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抗 CD19CAR-T 细胞疗法作为复发难治性弥漫大 B 细胞淋巴瘤二线治疗的系统综述与 meta 分析

英文原题:A systematic review and meta-analysis on utilizing anti-CD19 chimeric antigen receptor T-cell therapy as a second-line treatment for relapsed and refractory diffuse large B-cell lymphoma.

查看英文原题

A systematic review and meta-analysis on utilizing anti-CD19 chimeric antigen receptor T-cell therapy as a second-line treatment for relapsed and refractory diffuse large B-cell lymphoma.

PubMed 2024/07/18(内容时间) Front Oncol Q2 · IF 3.4(JCR 2025)

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研究概要

CAR-T 细胞疗法作为二线治疗,与 SOC 相比,在 R/R DLBCL 中似乎能有效实现更高的缓解率并延缓疾病进展。

研究思路结论见上方概要

近期评估CAR-T(CAR-T)细胞疗法作为二线治疗对比标准治疗(SOC)用于复发/难治性弥漫大B细胞淋巴瘤(R/R DLBCL)患者的III期试验结果不一致,促使进行了一项meta分析,以评估CAR-T 细胞疗法在该情况下的有效性。

采用随机效应meta分析合并效应估计值,以比较CAR-T 细胞疗法与SOC。采用频率学网络meta分析方法进行混合治疗比较。

对三项试验共865例患者的Meta分析显示,与SOC相比,CAR-T 细胞治疗显著改善无事件生存期(EFS:HR:0.51;95% CI:0.27-0.97;I2:92%)、无进展生存期(PFS:HR:0.47;95% CI:0.37-0.60;I2:0%)。尽管CAR-T 细胞治疗有潜在总生存期(OS)改善的信号,但两组间差异无统计学意义(HR 0.76;95% CI:0.56至1.03;I2:29%)。混合治疗比较显示,与tisa-cel相比,liso-cel(HR:0.37;95% CI:0.22-0.61)和axi-cel(HR:0.42;95% CI:0.29-0.61)具有显著的EFS获益。

展开英文摘要原文

Random-effects meta-analysis was conducted to pool effect estimates for comparison between CAR-T cell therapy and SOC. Mixed treatment comparisons were made using a frequentist network meta-analysis approach.

Meta-analysis of three trials with 865 patients showed significant improvement in event-free survival (EFS: HR: 0.51; 95% CI: 0.27-0.97; I2: 92%), progression-free survival (PFS: HR: 0.47; 95% CI: 0.37-0.60; I2: 0%) with CAR-T cell therapy compared to SOC. Although there was a signal of potential overall survival (OS) improvement with CAR-T cell therapy, the difference was not statistically significant between the two groups (HR 0.76; 95% CI: 0.56 to 1.03; I2: 29%). Mixed treatment comparisons showed significant EFS benefit with liso-cel (HR: 0.37; 95% CI: 0.22-0.61) and axi-cel (HR: 0.42; 95% CI: 0.29-0.61) compared to tisa-cel. DISCUSSION: CAR-T cell therapy, as a second-line treatment, appears to be effective in achieving higher response rates and delaying the disease progression compared to SOC in R/R DLBCL.

论文信息

作者
Asghar K、Zafar M、Holland E、Abduljabbar AB、Albagoush SA、Asghar N、Sood A、Dufani JM
第一作者单位
Department of Medicine, Dow Medical College, Karachi, Pakistan.
通讯作者单位
Department of Medicine, University of Arizona, Tucson, AZ, United States.United States
文献类型
系统综述
期刊
Frontiers in oncology2024
原文标识
PubMed 39091918 · DOI 10.3389/fonc.2024.1407001