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
英文原题:The impact of radiotherapy on the therapeutic response of patients treated with CAR T-cell therapy for high-grade lymphoma: a systematic review.
The impact of radiotherapy on the therapeutic response of patients treated with CAR T-cell therapy for high-grade lymphoma: a systematic review.
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CAR-T(CAR-T)细胞疗法是一种有前景的癌症治疗形式,在复发/难治性淋巴瘤中已证实有效。然而,其存在局限性,包括毒性、未能形成免疫记忆以及免疫逃逸。在CAR-T 治疗中联合放疗(RT)的理论依据包括增加抗原暴露和免疫激活。我们研究了在接受CD19 CAR-T 治疗的高级别淋巴瘤患者中使用RT的当前证据。关注的结局包括无进展生存期、完全缓解率、总生存期以及治疗相关毒性的发生率。共纳入5项研究,涵盖1034例患者。结果表明,RT是一种安全有效的桥接策略。RT与CAR-T 的联合与完全缓解率改善相关,但证据受到队列异质性和可能的选择偏倚的限制。需要进一步的前瞻性试验来证实这一点,并确定生存结局是否受到影响。
Chimeric antigen receptor T (CAR -T) cell therapy is a promising form of cancer treatment with proven efficacy in relapsed/refractory lymphomas.
However, there are limitations, including toxicity, failure to achieve immunological memory, and immune evasion. The rationale for administering radiotherapy (RT) with CAR -T, includes increased antigen exposure and immune activation.
We studied the current evidence for RT use in high-grade lymphoma patients treated with CD19 CAR-T therapy. The outcomes of interest included progression free survival, complete response rate, overall survival, and incidence of treatment associated toxicities. Five studies were included encompassing 1034 patients. The results indicate that RT is a safe and effective bridging strategy. The combination of RT and CAR-T is associated with improved complete remission rates, but the evidence is limited by cohort heterogeneity and possible selection bias.
Further prospective trials are required to confirm this and to determine whether survival outcomes are affected.
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