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:Chimeric antigen receptor T-cell therapy in relapsed or refractory mantle cell lymphoma: a systematic review and meta-analysis.
Chimeric antigen receptor T-cell therapy in relapsed or refractory mantle cell lymphoma: a systematic review and meta-analysis.
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CAR-T 疗法在 R/R MCL 患者中显示出有希望的疗效和可控的不良反应。
嵌合抗原受体(CAR)T细胞疗法(CAR-T 疗法)在ZUMA-2研究中显示出显著疗效。在获得监管批准后,针对复发/难治性套细胞淋巴瘤(R/R MCL)的CAR-T 疗法开展了多项临床试验和真实世界研究。然而,临床安全性和有效性数据并不一致。在本研究中,我们旨在对更广泛、更具代表性的R/R MCL患者队列中CAR-T 疗法的有效性和安全性进行系统性分析。
我们对接受CAR-T 细胞治疗的R/R MCL患者的研究进行了系统综述和meta分析。提取并整合了数据,主要关注安全性和有效性结局指标的评估。本研究未在PROSPERO注册。
本meta分析共纳入16项研究,涉及984例患者。总体缓解率(ORR)的合并估计值为89%;完全缓解(CR)率为74%。6个月和12个月无进展生存期(PFS)率分别为69%和53%,而总生存期(OS)率分别为80%和69%。3级或以上细胞因子释放综合征(CRS)见于8%的患者,而3级或以上神经毒性见于22%的患者。偏倚风险评估显示,9项研究为低风险,7项研究为中等风险。
Chimeric antigen receptor (CAR) T-cell therapy (CAR-T therapy) has demonstrated significant efficacy in the ZUMA-2 study. After regulatory approvals, several clinical trials and real-world studies on CAR-T therapy for relapsed or refractory mantle cell lymphoma (R/R MCL) were conducted. However, data on clinical safety and efficacy are inconsistent. In this study, we aimed to conduct a systematic analysis of the effectiveness and safety of CAR-T therapy across a wider and more representative cohort of patients with R/R MCL.
We performed a systematic review and meta-analysis of studies on patients with R/R MCL who received CAR-T cell therapy. Data were extracted and consolidated, with primary focus on the evaluation of safety and efficacy outcome measures. This study has not been registered with PROSPERO.
This meta-analysis identified and included 16 studies with 984 patients. The pooled estimate for overall response rate (ORR) was 89%; complete remission (CR) rate was 74%. The 6-month and 12-month progression-free survival (PFS) rates were 69% and 53%, respectively, while the overall survival (OS) rates were 80% and 69%, respectively. Cytokine release syndrome (CRS) of grade 3 or higher was observed in 8% of patients, whereas neurotoxicity of grade 3 or higher was observed in 22% of patients. The risk of bias was assessed as low in 9 studies and moderate in 7 studies.
CAR-T therapy exhibited promising efficacy and manageable adverse reactions in patients with R/R MCL.
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