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
真实世界环境中 CAR-T 治疗血液系统恶性肿瘤的安全性与疗效区域差异比较：系统综述与荟萃分析
英文原题：Comparison of regional differences in safety and efficacy of CAR-T therapy for hematologic malignancies in a real-world setting: a systematic review and meta-analysis.
查看英文原题
Comparison of regional differences in safety and efficacy of CAR-T therapy for hematologic malignancies in a real-world setting: a systematic review and meta-analysis.
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研究概要
北美患者具有更高的 CRS 发生率和 3 级 ICANS 发生率。
中文摘要
背景
嵌合抗原受体（CAR）T细胞疗法改变了血液系统恶性肿瘤的治疗格局。不过，不同地理区域的治疗结局可能存在差异，包括细胞因子释放综合征（CRS）、免疫效应细胞相关神经毒性综合征（ICANS）、总缓解率（ORR）和完全缓解率（CRR）。但相关真实世界研究和系统分析证据仍有限。
目的
本荟萃分析比较不同地区血液系统恶性肿瘤患者接受CAR-T 治疗后的真实世界CRS和ICANS发生率及ORR/CRR。
方法
系统检索PubMed、Embase和Cochrane图书馆截至2025年2月发表的文献，并根据地理区域及其他因素开展亚组分析。
结果
纳入来自4个地区的70个队列，共9,233例患者。北美CRS发生率最高，为83%，显著高于欧洲（82%）和亚洲（80%）（P<.01）。但3级CRS发生率无显著地区差异。北美ICANS发生率（39%）高于欧洲（32%）和亚洲（21%），差异未达到统计学显著性（P=.08）；北美3级ICANS发生率也更高（16%），欧洲为9%，亚洲为2%（P<.01）。不同地区的治疗疗效无差异。
结论
北美患者CRS和3级ICANS发生率较高。本研究为真实世界中不同地区CAR-T 治疗不良反应提供了有价值的见解。
展开英文摘要原文
BACKGROUND
Chimeric antigen receptor (CAR)-T cell therapy has transformed the treatment landscape of patients with hematologic malignancies. Nevertheless, geographic regions may lead to various outcomes, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), overall response rate (ORR), and complete response rate (CRR). However, the related evidence of real-world studies and systematic analysis remains limited.
OBJECTIVE
This meta-analysis aims to compare the real-world incidence of CRS and ICANS, as well as therapeutic outcomes ORR/CRR, in patients with hematologic malignancy treated with CAR-T therapy across different regions.
METHODS
A systematic literature search was conducted in Pubmed, Embase, and Cochrane Library databases published up to February 2025. Subgroup analyses were performed based on geographic regions and other factors.
RESULTS
Seventy corhorts from 4 different regions comprising 9233 patients were included. North America exhibited the highest incidence of CRS at 83 %, surpassing Europe (82 %) and Asia (80 %) significantly (p < 0.01). However, no significant regional differences existed in grade 3 CRS. The incidence of ICANS was notably higher in North America (39 %) compared to Europe (32 %) and Asia (21 %; p = 0.08), with grade 3 ICANS also more prevalent in North America (16 %) than in Europe (9 %) and Asia (2 %; p < 0.01). Efficacy did not vary across different regions.
CONCLUSION
Patients in North America possessing elevated rates of CRS and grade 3 ICANS. The results provide valuable insights to the adverse effects when treating patients with CAR-T therapy across different regions in a real-world setting.
论文信息
- 作者
- Chen Z、Luo W、Kang Y、Xu J、Li C、Wang X、Zhang Y、Liu Q
- 第一作者单位
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease, Wuhan 430022, China.China
- 通讯作者单位
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease, Wuhan 430022, China. Electronic address: hmei@hust.edu.cn.China
- 文献类型
- 系统综述 · 荟萃分析 · 对照研究
- 期刊
- Critical reviews in oncology/hematology2025 Dec
- 原文标识
- PubMed 41072894 · DOI 10.1016/j.critrevonc.2025.104969