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靶向 GPRC5D 的 CAR T 细胞疗法治疗多发性骨髓瘤患者的安全性和有效性的系统评价和荟萃分析:癌症免疫治疗的新见解

英文原题:A Systematic Review and Meta-analysis on the Safety and Efficacy of CAR T Cell Therapy Targeting GPRC5D in Patients with Multiple Myeloma: A New Insight in Cancer Immunotherapy.

PubMed 2025/01/01(内容时间) Anticancer Agents Med Chem Q3 · IF 2.6(JCR 2025)

研究概要

GPRC5D是一个活跃且安全的靶点,在治疗复发和/或难治性(R/R)MM及经过大量预处理的患者中显示出有希望的结果。

研究思路结论见上方概要

尽管多发性骨髓瘤(MM)的治疗不断取得进展并引入了创新性治疗方法,但复发仍很常见,总生存率较低。G蛋白偶联受体C类第5组成员D(GPRC5D)已在多种骨髓瘤细胞系中表达,并在体外研究中作为免疫治疗的潜在靶点显示出令人鼓舞的结果。

我们旨在研究靶向GPRC5D的CAR T细胞疗法在MM患者中的安全性和疗效。

2023年8月24日,系统检索了PubMed、Scopus、Embase和Web of Science数据库中的相关研究。完成标题/摘要和全文的两步筛选流程后,纳入符合条件的研究。

在筛选了107篇文章后,纳入了4项研究,涉及130名接受GPRC5D靶向CAR T细胞治疗的多发性骨髓瘤患者。荟萃分析显示,ORR为87%(95% CI [81-93%]),既往接受过BCMA靶向治疗的患者为74%(95% CI [65-73%]),未接受过的患者为88%(95% CI [78-99%])。PR为25%,VGPR为33%,CR/sCR为48%,65%达到MRD阴性。在安全性方面,血液学AEs常见,86%的患者报告贫血。非血液学常见AEs包括CRS(83%,5%为3级)和低钙血症(63%,10%为3级)。未检测到显著的发表偏倚。

展开英文摘要原文

BACKGROUND: Despite ongoing advances and introducing innovative therapeutic approaches for the treatment of multiple myeloma (MM), relapses are common, with low overall survival rates. G protein-coupled receptor, class C, group 5, and member D (GPRC5D) has been expressed in several myeloma cell lines and has demonstrated encouraging outcomes results in in-vitro studies as a potential target for immunotherapies. OBJECTIVE: We aimed to investigate the safety and efficacy of GPRC5D-targeted CAR T cell therapies in MM patients. METHODS: On August 24, 2023, the databases of PubMed, Scopus, Embase, and Web of Science were systematically searched for pertinent studies. After completing a two-step title/abstract and full-text screening process, the eligible studies were included. RESULTS: Following the screening of 107 articles, four studies of 130 multiple myeloma patients treated with GPRC5D-targeted CAR T-cell therapy were included. The meta-analyses showed an ORR of 87% (95% CI [81- 93%]), with 74% (95% CI [65-73%]) for those with prior BCMA-targeted therapy and 88% (95% CI [78-99%]) for those without. PR was 25%, VGPR 33%, and CR/sCR 48%, with 65% achieving MRD-negativity. In terms of safety, hematologic AEs were common, with anemia reported in 86% of patients. Non-hematologic common AEs included CRS (83%, 5% grade 3) and hypocalcemia (63%, 10% grade 3). No significant publication bias was detected. CONCLUSION: GPRC5D is an active and safe target that shows promising results in the treatment of relapsed and/or refractory (R/R) MM and heavily pretreated patients.

论文信息

作者
Robat-Jazi B、Mahalleh M、Dashti M、Nejati N、Ahmadpour M、Alinejad E、Mohammadi S、Lorestani P
第一作者单位
Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran.Iran
通讯作者单位
Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.Iran
文献类型
系统综述 · 荟萃分析
期刊
Anti-cancer agents in medicinal chemistry2025
原文标识
PubMed 39901537 · DOI 10.2174/0118715206350342241224073809