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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
美国医疗索赔数据库中弥漫大 B 细胞淋巴瘤患者的真实世界治疗模式与临床结局
英文原题：Real-world treatment patterns and clinical outcomes among patients with diffuse large B-cell lymphoma in a US healthcare claims database.
查看英文原题
Real-world treatment patterns and clinical outcomes among patients with diffuse large B-cell lymphoma in a US healthcare claims database.
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中文摘要
弥漫性大B细胞淋巴瘤（DLBCL）的治疗选择已有所扩展，但关于治疗模式和结局的真实世界数据仍然有限。本研究考察了2015年10月1日至2024年6月30日期间接受治疗的DLBCL患者的真实世界结局。患者按治疗线数（LOT）和治疗方案进行分层（1L利妥昔单抗、环磷酰胺、多柔比星、长春新碱、泼尼松[R-CHOP]；2L干细胞移植[SCT]；以及CAR-T 细胞[CAR-T]疗法（任何LOT））。变量以描述性方式报告。时间-事件结局采用Kaplan-Meier法评估。共纳入9875例患者的LOT数据。以R-CHOP为基础的方案是最常见的1L治疗（2016-2023年为61.7%-67.3%；2024年为49.4%）。
传统化学免疫治疗的使用在2L（从2016年的81.6%降至2024年的41.9%）和3L（从2016年的47.6%降至2024年的22.1%）中减少，而新型疗法增加（2024年2L为43.0%，3L为55.9%）。中位总生存期随LOT下降（1L：58.1个月；2L：30.0个月），中位至下次治疗时间亦然（1L：36.1个月；2L：10.6个月）。12个月治疗失败率在1L后为36.0%，2L后为51.8%，CAR-T 后为42.2%。在CAR-T 接受者中，93例接受了36种不同后续方案中的一种，表明尚无标准治疗。这些发现凸显了DLBCL中未被满足的需求。
展开英文摘要原文
Treatment options for diffuse large B-cell lymphoma (DLBCL) have expanded, but real-world data on treatment patterns and outcomes remain limited.
This study examined real-world outcomes in DLBCL patients treated between 10/1/2015 and 6/30/2024. Patients were stratified by lines of therapy (LOT) and treatments (1L rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone [R-CHOP]; 2L stem cell transplant [SCT]; and chimeric antigen receptor T-cell [CAR T] therapy (any LOT). Variables were reported descriptively. Time-to-event outcomes were assessed using the Kaplan-Meier method. LOT data from 9875 patients were included. R-CHOP-based regimens were the most common 1L treatment (61. 7%-67. 3% in 2016-2023; 49.
4% in 2024). Conventional chemoimmunotherapy use decreased in 2L (81. 6% in 2016 to 41. 9% in 2024) and 3L (47. 6% in 2016 to 22. 1% in 2024), while novel therapies increased (43. 0% in 2L and 55. 9% in 3L in 2024). Median overall survival declined across LOT (1L: 58. 1 months; 2L: 30.
0 months), as did median time to next treatment (1L: 36. 1 months; 2L: 10. 6 months). Twelve-month treatment failure rates were 36. 0% after 1L, 51. 8% after 2L, and 42. 2% after CAR T. Among CAR T recipients, 93 received one of 36 distinct subsequent regimens, indicating no standard of care.
These findings highlight the unmet needs in DLBCL.
论文信息
- 作者
- Shadman M、Harper JS、Bokun A、Xu C、Lin P、Graf G、Lu X
- 单位
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA. mshadman@gmail.com.United States
- 期刊
- Blood cancer journal2025 Dec 5
- 原文标识
- PubMed 41345384 · DOI 10.1038/s41408-025-01412-8
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