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:Celebrating the registration of 9.000 patients treated with CAR T cells in the EBMT registry: Collection of real-world data in the context of hematopoietic cellular therapies.
Celebrating the registration of 9.000 patients treated with CAR T cells in the EBMT registry: Collection of real-world data in the context of hematopoietic cellular therapies.
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欧洲血液与骨髓移植学会(EBMT)长期以来一直关注造血细胞移植的评估。三十多年前,其成员建立了一个洲际登记系统。如今,已有超过700,000名患者被登记,并收集了超过800,000例移植的信息。这一庞大的信息量使得能够开展多项回顾性研究,评估随着时间推移以及针对不同疾病类别的实践变化,对EBMT附属中心的结果进行基准比较,并日益用于构建合成对照,以评估血液学领域治疗创新的引入。CAR-T 细胞疗法所依赖的人力和技术资源同样用于实施HCT;它们引发的副作用需要实施风险缓解计划;它们是持久存在于受者体内的活体药物,因此需要长期随访;CAR-T 细胞进入药典可能对BMT的实践产生重大影响;基于所有这些原因,甚至在CAR-T 细胞在欧洲首次获批之前,EBMT就启动了一个项目,旨在通过细胞治疗表单补充EBMT登记系统,目的是登记接受CAR-T 细胞治疗的患者,并收集其短期、中期和长期结局的信息。
目标是为 EBMT 研究者提供一个工具,用于对收集到的信息进行初步分析,并支持将个体层面传输的数据二次用于上市许可持有人和其他相关方,以履行其对卫生主管部门的义务,并进一步评估 CAR-T 细胞在不同背景和适应症中的实际医学价值。EBMT 登记处于 2019 年获得欧洲药品管理局的积极意见,五年后已包含超过 9.000 名接受治疗患者的信息。本文描述了启动这一新活动的历程、在改进真实世界数据收集方面应吸取的经验教训,以及现有信息在患者可及性方面告诉我们的内容。
The European society for Blood and Marrow Transplantation (EBMT) has a long-standing interest in the evaluation of hematopoietic cell transplantation. More than three decades ago, its members established a continental registry. Today, more than 700,000 patients have been registered, and information has been gathered on more than 800,000 transplants. This huge amount of information has allowed conducting multiple retrospective studies, evaluating changes in practices over time and for different categories of diseases, benchmarking outcome across EBMT affiliated centers, and increasingly serves to build synthetic comparators to evaluate the introduction of therapeutic innovations in the field of hematology. CAR-T cells therapies draw on human and technical resources that are also used to deliver HCT; they elicit side effects that require the implementation of risk mitigation plans; they are living drugs that persist in the body of the recipient and thus deserve prolonged follow-up; the introduction of CAR-T cells in the pharmacopeia is likely to significantly impact on the practice of BMT; for all these reasons and even before the first approvals of CAR-T Cells in Europe, EBMT engaged in a project aiming at complementing the EBMT Registry with a Cellular Therapy Form, with the objective to register CAR-T cells treated patients and collect information on their short-, middle- and long-term outcome.
The goal is to provide EBMT investigators with a tool for primary analyses of the collected information and to support secondary use of data transferred at the individual level to Marketing Authorization Holders and other interested parties, to fulfill their obligations to health authorities and further evaluate the actual medical values of CAR-T Cells in different contexts and indications.
The EBMT Registry received a positive opinion from the European Medicines agency in 2019, and five years later contains information on more than 9. 000 treated patients. This article describes the journey to start this new activity, lessons to be drawn in view of improving the collection of real-world data, and what existing information tells us in terms of patient access.
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