← 返回

血液系统恶性肿瘤患者 CAR-T 细胞治疗后的患者报告结局

英文原题:Patient-reported outcomes after CAR T-cell therapy in patients with hematological malignancies.

查看英文原题

Patient-reported outcomes after CAR T-cell therapy in patients with hematological malignancies.

PubMed 2024/12/06(内容时间) Hematology Am Soc Hematol Educ Program Q1 · IF 3.7(JCR 2025)

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

中文摘要

接受嵌合抗原受体(CAR)T细胞疗法的血液系统恶性肿瘤患者生存显著改善,这凸显了在患者管理指南中纳入以患者为中心评估的日益迫切需求。CAR-T 疗法具有独特毒性,并且细胞输注后的前几周症状负担相对较高,这已为人熟知。采用患者报告结局(PRO)倾听患者声音,可支持急性照护中的个体化干预、优化医疗资源使用、提高治疗满意度并改善生存获益。

然而,多种因素阻碍了PRO在常规患者照护中的应用:(1)治疗急性期进行PRO评估是否可行,尤其是发生神经毒性的患者,尚未明确;(2)尽管PRO已广泛用于药物开发试验,临床试验评估工具主要用于比较各研究组生活质量或安全性,通常并不适合评估和捕捉常规患者照护中需要监测、且具有临床意义的不良事件;(3)可指导长期生存者监测并捕捉CAR-T 迟发效应的PRO数据有限。亟需克服这些障碍,将循证PRO整合至CAR-T 患者标准治疗指南中。本综述介绍CAR-T 疗法中PRO应用现状,并讨论在患者照护中成功实施PRO的实用方法和未来方向。

展开英文摘要原文

The remarkable improvement in survival among individuals with hematological malignancies receiving chimeric antigen receptor (CAR) T-cell therapy has highlighted the growing unmet need to incorporate patient-centered assessments in management guidelines for these patients.

That CAR T-cell therapy is associated with unique toxicities and relatively high symptom burden in the first few weeks after cell infusion is well known. Magnifying the patient's voice by using patient-reported outcomes (PROs) might support personalized intervention in the acute-care setting, optimize the use of medical resources, improve satisfaction with therapy, and enhance survival benefit.

However, various factors impede PRO use in routine patient care: (1) the feasibility of PRO assessment during the acute phase of treatment, especially in patients experiencing neurological toxicities, is not well established; (2) although PROs are widely used in drug- development trials, the assessment tools used in clinical trials primarily inform quality-of-life or safety comparisons among study arms and are rarely the proper tools for assessing and capturing clinically meaningful adverse events that should be monitored in routine patient care; (3) PRO data that could guide how best to monitor and capture the delayed effects of CAR T-cell therapy in long-term survivors are limited.

There is a pressing need to overcome these barriers to integrating evidence-based PROs into standard-of-care guidelines for patients receiving CAR T-cell therapy. In this review, we present the current state of PRO utilization in CAR T-cell therapy.

We also discuss practical approaches and future directions for successful implementation of PROs in the care of patients receiving CAR T-cell therapy.

论文信息

作者
Wang XS、Srour SA
单位
University of Texas M.D. Anderson Cancer Center, Houston, TX.United States
文献类型
综述
期刊
Hematology. American Society of Hematology. Education Program2024 Dec 6
原文标识
PubMed 39644035 · DOI 10.1182/hematology.2024000536