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:The safety and efficacy of GD2-targeted CAR-T cells in patients with neuroblastoma: a systematic review and meta-analysis.
靶向 GD2 抗原的 CAR-T 细胞疗法在治疗 NB 方面前景广阔。
目的:神经母细胞瘤(NB)是常见且危及生命的儿童实体瘤,预后较差,高危患者尤为如此。尽管抗二唾液酸神经节苷脂GD2单克隆抗体可改善生存,但复发和耐药仍是重大挑战。本研究旨在评估GD2靶向嵌合抗原受体(CAR)T细胞疗法在NB患者中的安全性和疗效。 方法:研究者检索了PubMed、Embase、Scopus和Web of Science截至2025年9月30日的文献。符合条件的研究为评估GD2靶向CAR-T细胞疗法在NB患者中的疗效和安全性的临床试验。两名评审者独立进行研究筛选、数据提取和偏倚风险评估。采用随机效应荟萃分析模型计算汇总结果。 结果:共纳入8项研究,涉及146例NB患者。汇总完全缓解(CR)率为39.57%(21.17–57.96),部分缓解(PR)率为15.83%(5.02–30.45)。疾病进展(PD)和疾病稳定(SD)比例分别为20.9%(3.06–46.67)和30.76%(12.81–51.91)。最常见的任何级别不良事件为贫血,发生率97.43%(81.51–100);最常见的3级不良事件为中性粒细胞减少,发生率93.46%(72.65–100)。亚组分析显示,CAR-T细胞的制备方式及其组成会影响疗效和安全性。 结论:靶向GD2抗原的CAR-T细胞疗法在治疗NB方面具有前景,但疗效中等,且治疗可能导致贫血、中性粒细胞减少和血小板减少等血液学毒性,需要密切监测。
OBJECTIVES: Neuroblastoma (NB) is a common and life-threatening pediatric solid tumor with a poor prognosis, especially in high-risk patients. Although anti-disialoganglioside GD2 (GD2) monoclonal antibodies improve survival, relapse and resistance remain major challenges. This study aimed to evaluate the safety and efficacy of GD2-targeted chimeric antigen receptor (CAR)-T-cell therapy in NB patients. METHODS: A literature search was conducted in PubMed, Embase, Scopus, and Web of Science until September 30, 2025. Eligible studies were clinical trials that evaluated the efficacy and safety of GD2-targeted CAR-T-cell therapy in NB patients. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. The random-effects meta-analysis model was used to calculate pooled amounts. RESULTS: Eight studies that included 146 patients with NB were included. The pooled complete response (CR) rate was 39.57% (21.17-57.96), and the partial response (PR) rate was 15.83% (5.02-30.45). Additionally, the rates of progressive disease (PD) and stable disease (SD) were 20.9% (3.06-46.67) and 30.76% (12.81-51.91), respectively. The most common "any grade" adverse events (AEs) was anemia, at 97.43% (81.51-100), and the most common "grade 3" AEs was neutropenia, at 93.46% (72.65-100). Subgroup analyses revealed that CAR-T-cell generation and its components influenced efficacy and safety. CONCLUSION: CAR-T-cell therapy targeting the GD2 antigen is promising for treating NB. However, its efficacy is moderate, and treatment can lead to hematologic toxicities such as anemia, neutropenia, and thrombocytopenia, which require careful monitoring.
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