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CAR-T 细胞治疗复发/难治性套细胞淋巴瘤:一项系统综述与荟萃分析

英文原题:Chimeric antigen receptor T-cell therapy in relapsed or refractory mantle cell lymphoma: a systematic review and meta-analysis.

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Chimeric antigen receptor T-cell therapy in relapsed or refractory mantle cell lymphoma: a systematic review and meta-analysis.

PubMed 2024/09/06(内容时间) Front Immunol Q1 · IF 7(JCR 2025)

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研究概要

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。

研究思路结论见上方概要

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。

展开英文摘要原文

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.

论文信息

作者
Wan H、Weng S、Sheng S、Kuang Z、Wang Q、Hu L
单位
Jiangxi Provincial Key Laboratory of Hematological Diseases, Department of Hematology, The 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.China
文献类型
系统综述 · 荟萃分析
期刊
Frontiers in immunology2024
原文标识
PubMed 39308870 · DOI 10.3389/fimmu.2024.1435127