CAR-T cell therapy in T-Cell lymphoblastic leukemia/lymphoma: where do we stand now?

IF 2.8 3区医学 Q2 ONCOLOGY

Expert Review of Anticancer Therapy Pub Date : 2025-08-01 Epub Date: 2025-06-08 DOI:10.1080/14737140.2025.2515981

Pedro Chorão, Pilar Lloret, Pau Montesinos, Manuel Guerreiro

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引用次数: 0

Abstract

Introduction: CAR-T therapies for relapsed or refractory (r/r) T-cell lymphoblastic leukemia/lymphoma (T-LL/L) faces challenges, with most clinical studies conducted in small, dispersed cohorts and often reviewed alongside preclinical studies. This review focuses exclusively on clinical studies, evaluating CAR constructs, safety and efficacy.

Methods: A systematic review was conducted of databases, clinical trial registries, and abstracts from conferences (June 2014 to June 2024). Preclinical studies and studies lacking clinical details were excluded. Data on patient demographics, CAR-T characteristics, response rates, survival, and adverse events were analyzed.

Results: Eleven CAR-T constructs targeting CD7 and two targeting CD5 were identified. Complete remission (CR/CRi) rates ranged from 55% to 100%, exceeding 80% in most studies. Relapse, often in extramedullary sites, ranged from 7% to 66%. Cytokine release syndrome and neurotoxicity were generally manageable. GVHD incidence varied (none to 60%), primarily in allogeneic CAR-T recipients. Infections contributed to 6-38% of treatment-related mortality.

Conclusions: CAR-T therapy achieves high response rates in r/r T-LL/L and may serve as a bridge to allogeneic transplantation. However, the short follow-up and the duration of responses remain concerns, and challenges endure, including GVHD, immune recovery and infection control. Standardized reporting is crucial to optimize therapy outcomes and safety in future trials.

Registration: PROSPERO (CRD420251024662).

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CAR-T细胞治疗t淋巴母细胞白血病/淋巴瘤：目前进展如何？

CAR-T治疗复发或难治性（r/r） t淋巴细胞白血病/淋巴瘤（T-LL/L）面临挑战，大多数临床研究都是在小范围、分散的队列中进行的，并且经常与临床前研究一起进行回顾。这篇综述专注于临床研究，评估CAR结构、安全性和有效性。方法：系统回顾数据库、临床试验注册库和会议摘要（2014年6月至2024年6月）。临床前研究和缺乏临床细节的研究被排除在外。分析了患者人口统计学、CAR-T特征、反应率、生存率和不良事件的数据。结果：共鉴定出11个靶向CD7的CAR-T构建体和2个靶向CD5的CAR-T构建体。完全缓解（CR/CRi）率从55-100%不等，在大多数研究中超过80%。复发，常在髓外部位，范围从7-66%。细胞因子释放综合征和神经毒性一般是可控的。GVHD的发病率各不相同（无至60%），主要发生在同种异体CAR-T受体中。感染占治疗相关死亡率的6-38%。结论：CAR-T治疗在r/r T-LL/L中获得了很高的应答率，可能成为异基因移植的桥梁。然而，随访时间短和反应持续时间仍然令人担忧，包括GVHD，免疫恢复和感染控制在内的挑战仍然存在。标准化报告对于优化未来试验的治疗结果和安全性至关重要。报名：普洛斯彼罗（CRD420251024662）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anticancer Therapy 医学-肿瘤学

CiteScore

5.10

自引率

3.00%

发文量

100

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.