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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Safety and efficacy of anti-CD30 CAR-T cell therapy in relapsed/refractory classic Hodgkin lymphoma: a systematic review and meta-analysis.
Safety and efficacy of anti-CD30 CAR-T cell therapy in relapsed/refractory classic Hodgkin lymphoma: a systematic review and meta-analysis.
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现有证据表明,抗 CD30 CAR-T 细胞治疗在 R/R cHL 的治疗中有效且安全,值得作为一种可行的治疗选择加以考虑。
复发/难治性经典霍奇金淋巴瘤(R/R cHL)仍难以治疗,抗CD30CAR-T 细胞疗法可能有效。本荟萃分析评估抗CD30 CAR-T 治疗R/R cHL的疗效与安全性。
系统检索PubMed、Cochrane、Embase、ClinicalTrials.gov和Web of Science数据库,检索截至2024年2月。采用Review Manager 5.4分析比值比(OR)及95%置信区间(CI)。提取客观缓解率(ORR)、完全缓解(CR)、部分缓解(PR)、无进展生存期(PFS)、总生存期(OS)及不良事件(AE)等结局进行荟萃分析。采用非随机研究方法学指数(MINORS)评估纳入文献质量。
共纳入8条记录中的151名参与者。荟萃分析显示,CD30 CAR-T 治疗R/R cHL的ORR为57%(95% CI 0.36–0.76,P=0.50),CR率为34%(95% CI 0.13–0.64,P=0.29),PR率为32%(95% CI 0.15–0.55,P=0.12)。中位随访范围为9.5至71.5个月;1年PFS率为39%(95% CI 0.30–0.49,P=0.04),1年OS率为89%(95% CI 0.65–0.97,P=0.005)。最常见血液学AE为白细胞减少(72%,95% CI 0.50–0.87),最常见非血液学AE为细胞因子释放综合征(CRS,43%,95% CI 0.14–0.76)。3级AE的合并比例为66%(95% CI 0.06–0.98;I²=93%;P=0.70);中性粒细胞减少和血小板减少比例分别为34%(95% CI 0.07–0.78;I²=85%;P=0.51)。所有AE均可耐受,并经治疗缓解。
现有证据提示,抗CD30 CAR-T 治疗R/R cHL有效且安全,值得作为可行治疗方案考虑。
Relapsed/refractory classic Hodgkin lymphoma (R/R cHL) remains challenging to treat, and anti-CD30 chimeric antigen receptor T (CAR-T) cell therapy may be effective. This meta-analysis investigates the efficacy and safety of anti-CD30 CAR-T cell therapy for treating R/R cHL.
A systematic literature search of PubMed, Cochrane, Embase, ClinicalTrials.gov, and Web of Science databases was conducted until February 2024. The odds ratio (OR) with a 95% confidence interval (CI) was analysed using Review Manager 5.4. Outcomes including overall response rate (ORR), complete response (CR), partial response (PR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were extracted for meta-analysis. We used the Methodological Index for Non-Randomized Studies (MINORS) to evaluate the quality of the included literature.
A total of 151 participants from 8 records were included. Meta-analysis showed the ORR of CD30 CAR-T cell therapy for R/R cHL was 57% (95%CI 0.36-0.76, P = 0.50), with a CR of 34% (95%CI 0.13-0.64, P = 0.29) and a PR of 32% (95%CI 0.15-0.55, P = 0.12). With the median follow-up range from 9.5 to 71.5 months, the 1-year PFS was 39% (95% CI 0.30-0.49, P = 0.04), and the 1-year OS was 89% (95% CI 0.65-0.97, P = 0.005). The most common hematologic AE was leukopenia (72%, 95% CI: 0.50-0.87), and the most common non-hematological AE was cytokine release syndrome (CRS) (43%, 95% CI: 0.14-0.76). The grade 3 AEs was 66% (95%CI 0.06-0.98, I2 = 93%, P = 0.70), 34% (95%CI 0.07-0.78, I2 = 85%, P = 0.51) in neutropenia and thrombocytopenia, respectively. All AEs were tolerable and resolved with treatment.
Current evidence suggests that anti-CD30 CAR-T cell therapy is effective and safe in treating R/R cHL and is worth considering as a viable therapeutic option.
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