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AML 中 CAR-T 细胞临床试验实施与报告的国际共识指南

英文原题:International consensus guidelines for the conduct and reporting of CAR T-cell clinical trials in AML.

查看英文原题

International consensus guidelines for the conduct and reporting of CAR T-cell clinical trials in AML.

PubMed 2025/12/09(内容时间) Blood Adv Q1 · IF 7.7(JCR 2025)

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中文摘要

急性髓系白血病(AML)患者接受 CAR-T 治疗的早期临床经验显示,毒性发生率高而缓解率低。研究者组织了一场国际研讨会,汇集 AML 靶向 CAR-T 领域研究人员,讨论挑战并共同构思潜在解决方案。研讨会讨论表明:(1)用 CAR-T 治疗和靶向 AML 存在独特临床挑战;(2)临床试验设计、毒性定义、相关数据收集和报告方法存在差异,妨碍不同研究结局比较和最佳实践制定。此外,已发表研究并未统一报告 CAR-T 的基本特征和疗效、毒性的关键相关指标,限制了对成功障碍的理解。这些观察促成跨中心团队协作,由成人和儿童中心的基础/转化科学及临床研究专家共同精简临床试验设计和报告的关键要素。专家讨论并达成共识标准,最终形成白皮书。这些指南旨在提升 AML 靶向 CAR-T 研究的整体质量,使不同试验结果可比较,并为 AML 靶向 CAR-T 疗法下一阶段开发提供依据,以期改善患者结局。

展开英文摘要原文

Early clinical experience with the use of chimeric antigen receptor (CAR) T-cell therapies for patients with acute myeloid leukemia (AML) has been beset by high rates of toxicities and low rates of response.

We convened an international workshop with the goal of bringing investigators in the field of AML-directed CAR T-cell therapy together to facilitate discussion of challenges and to brainstorm potential solutions.

Based on discussions at the workshop, it was evident that (1) treating and targeting AML with CAR T cells is associated with unique clinical challenges, and (2) variability in clinical trial design, definitions of toxicities, correlative data collection, and reporting methods hinders the field's ability to compare study outcomes and to develop best practices.

Further, details of fundamental CAR T-cell attributes and key correlates of efficacy and toxicity were not uniformly reported in published studies, limiting understanding of barriers to success. These observations led to a concerted team effort in which experts in basic/translational science and clinical investigation from pediatric and adult centers worked together to streamline key attributes of clinical trial design and reporting.

Consensus criteria were discussed and agreed upon, leading to the creation of a white paper. These guidelines aim to bolster the overall quality of AML-directed CAR T-cell research, allow for comparisons across trials, and inform the next phase of development of AML-directed CAR T-cell therapies that we hope will improve patient outcomes.

论文信息

作者
Naik S、Aplenc R、Baumeister SHC、Becilli M、Bhagwat AS、Bonifant CL、Budde LE、Chien CD
第一作者单位
Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN.
通讯作者单位
Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.United States
期刊
Blood advances2025 Dec 9
原文标识
PubMed 40829117 · DOI 10.1182/bloodadvances.2025017011