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
输注前 18F-FDG PET/CT 对接受 CAR-T 细胞治疗的 B 细胞非霍奇金淋巴瘤患者的预后与毒性预测
英文原题：Pre-infusion 18 F-FDG PET/CT for Prognostic and Toxicity Prediction in B-cell Non-Hodgkin Lymphoma Patients Undergoing Chimeric Antigen Receptor T-cell Therapy.
查看英文原题
Pre-infusion 18 F-FDG PET/CT for Prognostic and Toxicity Prediction in B-cell Non-Hodgkin Lymphoma Patients Undergoing Chimeric Antigen Receptor T-cell Therapy.
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研究概要
治疗前 PET/CT 参数 SUVmax 似乎是疗效和预后一个有前景的预测因素，且与 CRS 的发生相关。
中文摘要
目的
评估18F-FDG PET/CT预测接受CAR-T（CAR-T）细胞治疗的B细胞非霍奇金淋巴瘤（B-NHL）患者结局和毒性的价值。
方法
本回顾性研究纳入接受CAR-T 治疗且有输注前18F-FDG PET/CT影像的B-NHL患者。记录SUVmax、代谢肿瘤体积（MTV）、总病灶糖酵解（TLG）及临床和实验室指标。主要终点为无进展生存期（PFS）和总生存期（OS）；采用Kaplan-Meier法估计生存，并分析PET/CT参数与客观缓解（OR）及细胞因子释放综合征（CRS）的相关性。
结果
共纳入133例患者，中位随访20.8个月。SUVmax（截断值15.65）是与PFS、OS和OR相关的独立代谢参数。SUVmax≥15.65者中位PFS为9.13个月（95% CI 0.11–18.16），SUVmax<15.65者尚未达到（P=.006）。前者平均OS也显著更短（26.89比45.14个月，P=.010），获得OR的比值比为.173（95% CI .056–.539）。其他与PFS相关的因素包括ECOG体能状态、B症状、大肿块和结外病灶；国际预后指数（IPI）和乳酸脱氢酶（LDH）与OS相关。SUVmax和Deauville评分与CRS发生呈弱正相关。
结论
治疗前PET/CT的SUVmax有望用于预测CAR-T 疗效和预后，并与CRS发生相关，可辅助患者选择及潜在副作用预测。
展开英文摘要原文
PURPOSE
The aim of this study was to evaluate the value of 18 F-FDG PET/CT in predicting outcomes and toxicity for patients with B-cell non-Hodgkin lymphoma (B-NHL) who underwent chimeric antigen receptor T (CAR-T) cell therapy.
METHODS
This retrospective study included B-NHL patients who underwent CAR-T therapy and had pre-infusion 18 F-FDG PET/CT images. We recorded SUVmax, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and various clinical and laboratory indexes. The primary endpoints were progression-free survival (PFS) and overall survival (OS). PFS and OS were estimated using the Kaplan-Meier method. In addition, we reported the correlation between PET/CT parameters and the objective response (OR), as well as cytokine release syndrome (CRS).
RESULTS
A total of 133 patients were enrolled in this study. The median follow-up duration was 20.8 months. SUVmax (with a cutoff value of 15.65) emerged as an independent metabolic parameter associated with PFS, OS, and OR. Patients with SUVmax 15.65 had a median PFS of 9.13 months (95% CI: 0.11-18.16), while the PFS for those with SUVmax<15.65 was not reached ( P =0.006). Furthermore, patients with SUVmax 15.65 exhibited significantly shorter average OS compared with those with SUVmax<15.65 (26.89 mo vs. 45.14 mo, P =0.010). In addition, the odds ratio for achieving an OR in patients with SUVmax 15.65 was found to be lower at 0.173 (95% CI: 0.056-0.539). Other factors associated with PFS included ECOG-PS, B symptoms, bulky mass, and extranodal sites, whereas IPI and LDH were associated with OS. Furthermore, SUVmax and Deauville scores showed a weak positive correlation with the occurrence of CRS.
CONCLUSIONS
The pretreatment PET/CT parameter SUVmax appears to be a promising predictive factor for efficacy and prognosis, as well as being associated with the occurrence of CRS. Consequently, we can conclude that this metabolic parameter from pretreatment PET/CT scans may serve as a valuable tool in guiding patient selection for CAR-T therapy and predicting potential side effects.
论文信息
- 作者
- Yao X、Wang H、Lei X、Yao S、Wang W、Yang J
- 单位
- Department of Nuclear Medicine, Beijing Friendship Hospital of Capital Medical University.China
- 期刊
- Clinical nuclear medicine2025 Jun 1
- 原文标识
- PubMed 40197422 · DOI 10.1097/RLU.0000000000005888