CAR-T（CAR-T）细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
种族和健康社会决定因素对接受 CAR-T 治疗的侵袭性 B 细胞 NHL 患者结局的影响
英文原题：Impact of race and social determinants of health on outcomes in patients with aggressive B-cell NHL treated with CAR-T therapy.
查看英文原题
Impact of race and social determinants of health on outcomes in patients with aggressive B-cell NHL treated with CAR-T therapy.
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中文摘要
嵌合抗原受体（CAR）T细胞（CAR-T）免疫治疗是复发/难治性B细胞非霍奇金淋巴瘤（r/r B-NHL）的有效疗法。然而，关于种族与健康社会决定因素交汇对接受CAR-T 治疗患者结局影响的数据有限。
我们考察了种族与保险类型之间的交互作用对接受CAR-T 治疗侵袭性B-NHL患者的医疗资源使用和结局的影响。我们纳入了2015年至2021年间在13个美国学术中心接受CD19 CAR-T 治疗的成人r/r B-NHL患者。收集并分析了保险类型、人口学和临床数据。共有466例成人患者纳入我们的分析。CAR-T 治疗后的中位随访时间为12.7个月。白种人的中位无进展生存期（mPFS）长于非裔美国人（11.5个月 vs 3.5个月；风险比[HR]，1.56 [1.03-2.4]；P = .04）或亚裔（2.7个月；HR，1.7 [1.02-2.67]；P = .04）。中位总生存期（mOS）差异无统计学意义。对于Medicare（n = 206）vs Medicaid（n = 33）vs 私人保险（n = 219）vs 自费（n = 7）：mPFS分别为15.9 vs 4.2 vs 6.0 vs 0.9个月（P < .001）；mOS分别为31.2 vs 12.8 vs 21.5 vs 3.2个月（P < .001）。
我们的多中心回顾性分析表明，种族和保险状况可影响接受CAR-T 治疗患者的结局。
展开英文摘要原文
Chimeric antigen receptor (CAR) T-cell (CAR-T) immunotherapy is an effective therapy for relapsed/refractory B-cell non-Hodgkin lymphoma (r/r B-NHL).
However, data are limited on the impact of the convergence of race and social determinants of health on outcomes for patients treated with CAR-T therapy.
We examined the impact of interactions between race and insurance type on health care use and outcomes in patients treated with CAR-T therapy for aggressive B-NHL. Adult patients with r/r B-NHL treated with CD19 CAR-Ts were identified between 2015 and 2021 across 13 US academic centers. Insurance type, demographic, and clinical data were collected and analyzed. In total, 466 adult patients were included in our analysis. Median follow-up after CAR-T therapy was 12. 7 months.
Median progression-free survival (mPFS) was longer for Caucasians (11. 5 months) than for African Americans (3. 5 months; hazard ratio [HR], 1. 56 [1. 03-2. 4]; P = . 04) or Asians (2. 7 months; HR, 1. 7 [1. 02-2. 67]; P = . 04). Differences in median overall survival (mOS) were not significant. For Medicare (n = 206) vs Medicaid (n = 33) vs private insurance (n = 219) vs self-pay (n = 7): mPFS was 15. 9 vs 4. 2 vs 6. 0 vs 0. 9 months (P < . 001), respectively; and mOS was 31. 2 vs 12. 8 vs 21. 5 vs 3. 2 months (P < . 001), respectively.
Our multicenter retrospective analysis showed that race and insurance status can affect outcomes for patients treated with CAR-T therapy.
论文信息
- 作者
- Karmali R、Machhi R、Epperla N、Shouse G、Romancik J、Moyo TK、Kenkre V、Ollila TA
- 单位
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL.United States
- 期刊
- Blood advances2024 May 28
- 原文标识
- PubMed 38531057 · DOI 10.1182/bloodadvances.2023011996
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