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
英文原题:Association of social vulnerability index and chimeric antigen receptor T-cell therapy administration, 2018-2023.
Association of social vulnerability index and chimeric antigen receptor T-cell therapy administration, 2018-2023.
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针对复发/难治性血液系统恶性肿瘤患者的CAR-T 细胞治疗需要大量就诊,这可能对较低社会经济地位(SES)的患者构成挑战。美国疾病控制与预防中心发布了社会脆弱性指数(SVI),该指数总结了地区层面的SES因素,用于预测居民如何应对压力源,包括新癌症诊断。我们使用全国性的MarketScan商业和Medicare保险索赔数据库,分析SVI与CAR-T 治疗完成之间的关联。我们进行了多变量logistic回归(调整患者层面协变量),发现居住在较高SVI(较低SES)地区的血液系统恶性肿瘤患者完成CAR-T 治疗的几率降低(白血病比值比[OR] 0.84,P = .02;淋巴瘤OR 0.72,P < .001;骨髓瘤OR 0.70,P < .001)。因此,减轻CAR-T 差异的策略可能应聚焦于居住在较高SVI地区的患者。
Chimeric antigen receptor T-cell (CAR T) therapy for patients with relapsed/refractory hematologic malignancies demands numerous visits, which may pose challenges for patients with lower socioeconomic status (SES). The Centers for Disease Control and Prevention publishes the Social Vulnerability Index (SVI), which summarizes area-level SES factors that predict how residents respond to stressors, including a new cancer -diagnosis.
We used the nationwide MarketScan commercial and Medicare insurance claims database to analyze the association between SVI and CAR T therapy completion.
We performed multivariable logistic regressions (adjusting for patient-level covariates) and found that patients with hematologic malignancies residing in areas of higher SVI (lower SES) have decreased odds of CAR T therapy completion (odds ratio [OR] 0. 84 for leukemia, P = . 02; OR 0. 72 for lymphoma, P < . 001; OR 0. 70 for myeloma, P < . 001).
Therefore, strategies to mitigate CAR T disparities may be focused on patients living in areas with higher SVI.
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