决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
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.
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。
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。
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.
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