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.
CAR-T（CAR-T）细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
放射桥接治疗增强大 B 细胞淋巴瘤中 CAR-T 疗效：真实世界单中心经验
英文原题：Enhancing CAR-T Efficacy in Large B-Cell Lymphoma with Radiation Bridging Therapy: A Real-World Single-Center Experience.
查看英文原题
Enhancing CAR-T Efficacy in Large B-Cell Lymphoma with Radiation Bridging Therapy: A Real-World Single-Center Experience.
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中文摘要
复发/难治性大 B 细胞淋巴瘤（LBCL）CAR-T 治疗的一项挑战，是在细胞制备期间控制疾病。本文报告本中心 100 例患者的真实世界结局，患者接受 axicabtagene ciloleucel（axi-cel，n = 50）或 tisagenlecleucel（tisa-cel，n = 50）。多数患者接受桥接治疗（BT），其中 48 例接受放疗桥接（RBT），32 例接受全身桥接治疗（SBT）。axi-cel 组最佳总体缓解率（ORR）为 84%（完全缓解［CR］78%），tisa-cel 组为 60%（CR 42%）。中位随访 16 个月时，axi-cel 组 12 个月无进展生存期（PFS）和总生存期（OS）率分别为 72% 和 82%；tisa-cel 组分别为 35% 和 57%。按桥接策略分组，RBT 组、未接受 BT 组和 SBT 组的 12 个月 PFS 分别为 60%、59% 和 35%（p = 0.06）。
值得注意的是，axi-cel 组中制备期间淋巴瘤未进展的患者（n = 24）12 个月 PFS 和 OS 率分别达到 91% 和 96%。axi-cel 组 CRS（92% 对 66%，p = 0.003）和神经毒性（任何级别 56% 对 10%，p < 0.001；3 级及以上 28% 对 4%，p = 0.002）更多。多变量分析显示，RBT 与 PFS 改善独立相关（HR 0.46，95% CI 0.22–0.96）。有待前瞻性验证，但 RBT 显示出改善 LBCL CAR-T 结局的潜力。
展开英文摘要原文
One challenge of chimeric antigen receptor T-cell therapy (CAR-T) for relapsed or refractory large B-cell lymphoma (LBCL) is achieving disease control during manufacturing.
We report real-word outcomes of 100 patients treated with axicabtagene ciloleucel (axi-cel, n = 50) or tisagenlecleucel (tisa-cel, n = 50) at our center. Most patients received bridging therapy (BT) with 48 undergoing radiation BT (RBT) and 32 receiving systemic BT (SBT). The best overall response rate (ORR) was 84% (78% complete response (CR)) for axi-cel and 60% (42% CR) for tisa-cel.
At a median follow-up of 16 months, 12-month progression-free survival (PFS) and overall survival (OS) were 72% and 82% for axi-cel, compared to 35% and 57% for tisa-cel. By the bridging approach, 12-month PFS was 60% with RBT, 59% without BT and 35% with SBT ( p = 0. 06).
Notably, axi-cel patients without lymphoma progression during manufacturing ( n = 24) achieved 12-month PFS and OS rates of 91% and 96%, respectively. Axi-cel was associated with more cytokine release syndrome (92% vs. 66%, p = 0. 003) and neurotoxicity (all-grade 56% vs. 10%, p < 0. 001, grade 328% vs. 4%, p = 0. 002). Multivariate analysis identified RBT as independently associated with improved PFS (HR 0. 46, 95% CI 0. 22-0. 96). Pending prospective validation, RBT shows promise for improving CAR-T outcomes in LBCL.
论文信息
- 作者
- Laverdure E、Mollica L、Ahmad I、Cohen S、Lachance S、Veilleux O、Bernard M、Marchand EL
- 单位
- Department of Medicine, Institut Universitaire d'Hémato-Oncologie et de Thérapie Cellulaire, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal, l, Montréal, QC HIT 2M4, Canada.Canada
- 期刊
- Current oncology (Toronto, Ont.)2025 Mar 17
- 原文标识
- PubMed 40136377 · DOI 10.3390/curroncol32030173
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