肿瘤细胞治疗研究
英文原题:CD22-targeted immunotherapy for B-cell acute lymphoblastic leukemia progressing following CD19-targeted immunotherapy.
CD22-targeted immunotherapy for B-cell acute lymphoblastic leukemia progressing following CD19-targeted immunotherapy.
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在 r/r B-ALL 中,CD19 靶向免疫治疗后进展的患者结局较差。CD22 靶向治疗,包括 CD22 CAR-T 细胞和 Inotuzumab Ozogamicin,作为替代方案显示出前景,尽管这些患者中的数据有限。
本研究回顾性分析了中国两个中心 43 例既往接受过 CD19 靶向治疗的 r/r B-ALL 患者。在这些患者中,27.9% 接受了 blinatumomab,58.1% 接受了 CD19 CAR-T 细胞,14% 接受了两者。CD19 靶向治疗后,34.9% 的患者发生 CD19 阴性复发,而其余患者维持 CD19 表达。后续治疗包括 CD22 CAR-T 细胞(55.8%)和 InO(44.2%)。中位年龄为 39(24-56)岁,总体 CR/CRi 率为 51.1%,30.2% 达到 MRD 阴性。在 22 例达到 CR/CRi 的患者中,13 例(59.1%)发生复发。中位无复发生存期(RFS)为 236 天(95% CI:132-未达到),中位 OS 尚未达到。多因素分析显示,CD22 CAR-T 和 Inotuzumab Ozogamicin 治疗的缓解率和生存期相似。伴有髓外疾病的患者缓解率更差,而既往对 CD19 靶向治疗耐药的患者 RFS 更短。CD22 靶向治疗为 CD19 靶向免疫治疗后进展的患者提供了潜在选择,但高复发率凸显出需要更好的策略来实现持久缓解。
Patients progressing after CD19-targeted immunotherapy in r/r B-ALL experience poor outcomes. CD22-targeted therapies, including CD22 CAR-T cells and Inotuzumab Ozogamicin, show promise as alternatives, although data in those patients is limited.
This study retrospectively analyzed 43 r/r B-ALL patients who had previously received CD19-targeted therapy at two centers in China. Among these patients, 27. 9% received blinatumomab, 58. 1% received CD19 CAR-T cells, and 14% received both. After CD19-targeted therapy, 34. 9% of patients experienced CD19-negative relapse, while the remaining patients maintained CD19 expression. Subsequent treatments included CD22 CAR-T cells (55. 8%) and InO (44. 2%). The median age was 39 (24-56) years, with an overall CR/CRi rate of 51. 1% and 30. 2% achieving MRD negativity. Among the 22 patients achieving CR/CRi, 13 (59.
1%) experienced relapse. The median relapse-free survival (RFS) was 236 days (95% CI: 132-unreached), and the median OS has not been reached. Multivariate analysis showed similar remission rates and survival for CD22 CAR-T and Inotuzumab Ozogamicin therapies.
Patients with extramedullary disease had worse remission rates, and those previously resistant to CD19-targeted therapy had shorter RFS. CD22-targeted therapies offer a potential option for patients progressing after CD19-targeted immunotherapy, but high relapse rates highlight the need for better strategies for lasting remission.
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