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.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Unscheduled health care interactions in patients with multiple myeloma receiving T-cell redirection therapies.
Unscheduled health care interactions in patients with multiple myeloma receiving T-cell redirection therapies.
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靶向B细胞成熟抗原(BCMA)的嵌合抗原受体(CAR)T细胞和双特异性抗体(BsAb)疗法的开发及日益广泛应用,显著改善了复发/难治性多发性骨髓瘤(R/RMM)患者结局。
然而,医疗资源利用作为生活质量指标,在这些日益扩大的治疗人群中尚未得到充分评估。我们开展回顾性队列研究,评估接受BCMA靶向BsAb或CAR-T 治疗并产生应答的R/RMM患者(N=46)非计划医疗接触(UHI)的频率和原因。研究还分析了远程UHI,包括致电医生诊所和通过在线患者门户发送消息。
结果显示,接受这些疗法的R/RMM患者几乎全部(89%)在治疗前125天内至少有一次UHI,平均每例患者3.7次。与接受CAR-T 治疗并应答的患者相比,接受BsAb并应答的R/RMM患者远程联系医生诊所的可能性显著更高(增加1.8倍;P=0.038),前往紧急护理中心的可能性也超过3倍(P=0.012)。这主要是因为BsAb患者报告轻度上呼吸道感染的次数增加。研究结果凸显了制定常见症状预先管理策略的必要性,以应对接受CAR-T 或BsAb治疗的R/RMM患者常见症状。这类预先管理可能显著减少这一脆弱患者群体不必要的医疗资源使用。
Outcomes for patients with relapsed/refractory multiple myeloma (R/RMM) have dramatically improved after the development and now growing utilization of B-cell maturation antigen-targeted chimeric antigen receptor (CAR) T-cell therapy and bispecific antibody (BsAb) therapy.
However, health care utilization as a quality-of-life metric in these growing populations has not been thoroughly evaluated.
We performed a retrospective cohort study evaluating the frequency and cause of unscheduled health care interactions (UHIs) among patients with R/RMM responding to B-cell maturation antigen-targeted BsAb and CAR T-cell therapies (N = 46). This included the analysis of remote UHIs including calls to physicians' offices and messages sent through an online patient portal.
Our results showed that nearly all patients with R/RMM (89%) receiving these therapies required a UHI during the first 125 days of treatment, with a mean of 3. 7 UHIs per patient. Patients with R/RMM responding to BsAbs were significantly more likely to remotely contact their physicians' offices (1.
8-fold increase; P = . 038) or visit an urgent care center (more than threefold increase; P = . 012) than patients with R/RMM responding to CAR T-cell therapies. This was largely due to increased reports of mild upper respiratory tract infections in BsAb patients.
Our results underscore the need to develop preemptive management strategies for commonly reported symptoms that patients with R/RMM experience while receiving CAR T-cell or BsAb therapies. This preemptive management may significantly reduce unnecessary health care utilization in this vulnerable patient population.
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