不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:CAR-NK cells to treat patients with cancer: a systematic scoping review of published studies and registered clinical trials.
CAR-NK cells to treat patients with cancer: a systematic scoping review of published studies and registered clinical trials.
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已发表研究中 CAR-NK 治疗后的临床结局和低不良事件发生率令人鼓舞。需要更大规模的对照试验来确认 CAR-NK 治疗的安全性和有效性。我们预计未来几年将有若干此类试验完成。
嵌合抗原受体NK 细胞(CAR-NK)为治疗恶性疾病提供了一种有前景的同种异体免疫效应细胞疗法。需要进行一项系统综述,以了解当前临床研究和已注册的活跃试验的范围,从而确定可加速更广泛临床采用的研究设计和细胞产品表征方面。
对截至2025年1月25日的所有出版物和截至2024年6月21日注册的临床试验进行了系统综述。我们提取了研究设计、患者特征、结局指标和细胞产品特征的信息。
共纳入2018年至2025年间发表的十项研究中的150例患者。血液系统恶性肿瘤是最常被研究的疾病(n = 6项研究)。所有已发表的研究均为非对照研究,仅四项研究报告了超过三例患者。CAR-NK产品最常来源于NK-92细胞系(四项研究)、脐带血(三项研究)、诱导多能干细胞(一项研究),或未报告来源(两项研究)。在CAR-NK细胞制造方法和给药剂量方面观察到相当大的异质性。B细胞淋巴瘤患者的完全缓解率范围为25-85%,取决于淋巴瘤亚型。缓解具有持久性,在最大规模的研究中中位缓解未达到,在第二项研究中70%的缓解者实现了1年持久缓解。不良事件不常见,未报告3级或以上细胞因子释放综合征病例,也未报告免疫效应细胞介导的神经毒性或移植物抗宿主病病例。在确定的50项注册试验中(n=2102例受试者待入组),血液系统恶性肿瘤(n = 34;68%)是最常被研究的疾病。
A systematic review of all publications (to January 25, 2025) and registered clinical trials (to June 21, 2024) was conducted. We extracted information on study design, patient characteristics, outcome measures, and cell product characterization.
A total of 150 patients in ten studies published between 2018 and 2025 were identified. Hematologic malignancies were examined most frequently (n = 6 studies). All published studies were uncontrolled, and only four reported on more than three patients. CAR-NK products were most frequently derived from the NK-92 cell line (four studies), umbilical cord blood (three studies), induced pluripotent stem cells (one study), or not reported (two studies). Considerable heterogeneity was observed regarding CAR-NK cell manufacturing methods and dosing. Complete response rates for patients with B cell lymphomas ranged from 25-85%, depending on lymphoma subtype. Responses were durable with median response not reached in the largest study and durable remission at 1-year in 70% of responders in a second study. Adverse events were uncommon with no cases of grade 3 or higher cytokine release syndrome and no cases of immune effector-cell mediated neurotoxicity or graft versus host disease reported. Among the 50 registered trials identified (n=2102 subjects to be enrolled), hematological malignancies (n = 34; 68%) were the most common diseases examined.
The clinical outcomes and low adverse event rates following CAR-NK therapy in published studies are encouraging. Larger controlled trials are needed to confirm the safety and efficacy of CAR-NK therapy. We anticipate the completion of several such trials in the coming years.
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