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:Enabling access to talicabtagene autoleucel in relapsed/refractory B-cell malignancies; multicenter real-world evidence on delivery, efficacy and safety.
Enabling access to talicabtagene autoleucel in relapsed/refractory B-cell malignancies; multicenter real-world evidence on delivery, efficacy and safety.
这些发现表明,tali-cel 已在大型队列中于多个中心成功实施,这可能有助于改善全球 CAR-T 的可及性。
Talicabtagene autoleucel (tali-cel) 是首个在印度获批用于复发/难治性 (r/r) B细胞急性淋巴细胞白血病 (B-ALL) 和 B细胞非霍奇金淋巴瘤 (B-NHL) 的靶向 CD19 的人源化 CAR-T 细胞疗法。在此,我们通过集中协调单元 (CCU) 整合了临床和制造运营,并评估了 tali-cel 的实施情况。纳入2023年11月15日至2025年1月31日期间在56个治疗中心接受白细胞分离术的 r/r B-ALL (n = 105) 和 r/r B-NHL (n = 145) 患者。CCU 实现了及时交付,在提出生产档期请求后一周内分配生产档期,中位静脉到静脉时间为29天(范围,16-102),且不受地理位置影响。在 r/r B-ALL 患者中,中位随访时间为14个月,中位总生存期 (OS) 未达到,无进展生存期 (PFS) 为18个月(范围:9-NR)。12个月 OS 和 PFS 分别为64% (95% CI: 53-72) 和55% (95% CI: 45-65)。在 r/r B-NHL 中,中位随访时间为13个月,中位 PFS 为11个月(范围:7-16),OS 未达到。12个月 OS 和 PFS 分别为63% (95% CI: 54-71) 和47% (95% CI: 38-56)。无患者接受巩固性干细胞移植。3/4级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) 和免疫效应细胞相关噬血细胞性淋巴组织细胞增生症样综合征 (IEC-HS) 分别发生在6%、4%和23%的 r/r B-ALL 患者以及6%、3%和18%的 r/r B-NHL 患者中。这些发现表明 tali-cel 在大型队列中跨多个中心成功实施,这可能有助于改善全球 CAR-T 的可及性。
Talicabtagene autoleucel (tali-cel) is the first humanized CD19-directed CAR-T cell therapy approved in India for relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (B-ALL) and B-cell non-Hodgkin lymphoma (B-NHL). Here, we integrated clinical and manufacturing operations through a centralized coordination unit (CCU) and evaluated tali-cel implementation. Patients with r/r B-ALL (n = 105) and r/r B-NHL (n = 145) who underwent leukapheresis between 15 November 2023 and 31 January 2025 across 56 treatment centers were included. The CCU enabled timely delivery, with manufacturing slot allocation within one week of slot request and a median vein-to-vein time of 29 days (range, 16-102), independent of geographic location. In r/r B-ALL patients, the median follow-up was 14 months, and the median overall survival (OS) not reached, and progression-free survival (PFS) was 18 months (range: 9-NR). The 12-month OS and PFS were 64% (95% CI: 53-72) and 55% (95% CI: 45-65). In r/r B-NHL, the median follow-up was 13 months and the median PFS was 11 months (range:7-16) and OS was not reached. The 12-month OS and PFS were 63% (95% CI: 54-71) and 47% (95% CI: 38-56). No patients underwent consolidative stem cell transplantation. Grade 3/4 cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and Immune Effector Cell-associated Hemophagocytic Lymphohistiocytosis-like Syndrome (IEC-HS) occurred in 6%, 4%, and 23% of r/r B-ALL and 6%, 3%, and 18% of r/r B-NHL patients, respectively. These findings demonstrate the successful implementation of tali-cel across multiple centers in a large cohort, which might contribute towards improving CAR-T access globally.
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