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:Phase 2 study of relmacabtagene autoleucel (CD19 CAR-T) for relapsed/refractory mantle cell lymphoma in Chinese adults.
Phase 2 study of relmacabtagene autoleucel (CD19 CAR-T) for relapsed/refractory mantle cell lymphoma in Chinese adults.
这些发现表明,relma-cel在中国R/R MCL患者中具有高缓解率、持久缓解和可控的安全性。
Relmacabtagene autoleucel(relma-cel)是一种抗CD19CAR-T 细胞疗法,已在中国获批用于复发/难治性(R/R)大B细胞淋巴瘤和滤泡性淋巴瘤。这项2期、开放标签、单臂、多中心研究评估了其在中国接受过大量既往治疗的R/R套细胞淋巴瘤(MCL)患者中的疗效和安全性。共纳入70例R/R MCL患者,既往接受过1至9种治疗(包括蒽环类或苯达莫司汀化疗、抗CD20抗体和Bruton酪氨酸激酶[BTK]抑制剂)。其中59例在白细胞分离术后接受了单次100 106 CAR阳性T细胞输注。主要终点为输注后3个月的客观缓解率(ORR),采用Lugano 2014标准评估。次要终点包括缓解持续时间(DOR)、无进展生存期(PFS)、总生存期(OS)和安全性。3个月时,ORR为71.19%(95%置信区间[CI],57.92-82.24),完全缓解率为59.32%(95% CI,45.75-71.93)。中位随访13.3个月(95% CI,9.04-18.69)后,中位DOR为18.1个月,PFS为15.5个月,OS为19.5个月。3级或以上治疗中出现的不良事件常见,包括中性粒细胞减少(76.3%)、白细胞减少(69.5%)和淋巴细胞减少(47.5%)。严重细胞因子释放综合征和神经毒性各发生于6.8%的患者,所有病例均完全缓解。未报告致死性事件。这些发现表明,relma-cel在中国R/R MCL患者中具有高缓解率、持久缓解和可控的安全性。该试验注册于www.clinicaltrials.gov,编号为#NCT04718883。
Relmacabtagene autoleucel (relma-cel), an anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy, is approved in China for relapsed/refractory (R/R) large B-cell lymphoma and follicular lymphoma. This phase 2, open-label, single-arm, multicenter study evaluated its efficacy and safety in Chinese patients with heavily pretreated R/R mantle cell lymphoma (MCL). A total of 70 patients with R/R MCL who had received 1 to 9 previous therapies (including anthracycline or bendamustine chemotherapy, anti-CD20 antibodies, and Bruton tyrosine kinase [BTK] inhibitors) were enrolled. Of these, 59 received a single infusion of 100 106 CAR-positive T cells following leukapheresis. The primary end point was the objective response rate (ORR) at 3 months after infusion, assessed using the Lugano 2014 criteria. Secondary end points included the duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety. At 3 months, the ORR was 71.19% (95% confidence interval [CI], 57.92-82.24) with a complete response rate of 59.32% (95% CI, 45.75-71.93). After a median follow-up of 13.3 months (95% CI, 9.04-18.69), the median DOR was 18.1 months, PFS was 15.5 months, and OS was 19.5 months. Grade 3 or higher treatment-emergent adverse events were common, including neutropenia (76.3%), leukopenia (69.5%), and lymphopenia (47.5%). Severe cytokine release syndrome and neurotoxicity occurred in 6.8% of patients each, and all cases resolved fully. No fatal events were reported. These findings demonstrate that relma-cel offers high response rates, durable remissions, and manageable safety in Chinese patients with R/R MCL. This trial was registered at www.clinicaltrials.gov as #NCT04718883.
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