大 B 细胞淋巴瘤患者 CAR-T 疗法失败后一线挽救治疗反应率的 Meta 分析。

IF 3.6 3区 医学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY
Expert Opinion on Biological Therapy Pub Date : 2024-05-01 Epub Date: 2024-05-16 DOI:10.1080/14712598.2024.2354371
Jaromir Tomasik, Dominik Bilicki, Grzegorz Władysław Basak
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引用次数: 0

摘要

导言:经嵌合抗原受体(CAR)-T疗法治疗后无反应或复发的大B细胞淋巴瘤(LBCL)患者的预后仍然不容乐观,目前尚未就最有效的挽救方案达成共识:我们对CAR-T复发/难治性LBCL一线治疗的完全应答率(CR)和总应答率(ORR)进行了随机效应荟萃分析。我们遵循PROSPERO(CRD42023473854)提供的预定方案:我们确定了 41 项研究,评估了以下干预措施:非 CD19 CAR-T、CD19 CAR-T、双特异性抗体 (BiTE)、来那度胺和泊拉珠单抗疗法、放疗、免疫检查点抑制剂 (ICI)、布鲁顿酪氨酸激酶抑制剂 (BTKi)。非 CD19 CAR-T 细胞产生的 CR 最佳(56%,CI:40-71%),明显高于除 CD19 CAR-T 外的其他干预措施(CR = 30%,CI:7-58%)。生物治疗、放疗、来那度胺和泊拉珠单抗治疗方案(CR:分别为28%、26%、19%和24%)之间没有明显差异。ICI和BTKi的CR率最低(分别为12%,CI:5-20%和8%,CI:0-23%),也明显低于BiTEs。非 CD19 CAR-T 的 ORR 最高(ORR = 80%,CI:66-92%),而其他疗法的 ORR 值均低于 50%:结论:非 CD19 CAR-T 细胞具有更高的反应率,如果患者符合条件,应考虑使用非 CD19 CAR-T 细胞。结论:非CD19 CAR-T细胞与较高的应答率相关,如果患者符合条件,应考虑使用非CD19 CAR-T细胞。鉴于估计值的异质性,应谨慎解释结果:ProCORD42023473854.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Meta-analysis of response rates to first-line salvage treatment after CAR-T therapy failure in large B-cell lymphoma patients.

Introduction: The prognosis for large B-cell lymphoma (LBCL) patients who did not respond or relapsed after chimeric antigen receptor (CAR)-T therapy remains dismal, with no established consensus on the most effective salvage regimen.

Methods: We conducted a random-effects meta-analysis of complete response (CR) and overall response rates (ORR) to first-line treatments for CAR-T-relapsed/refractory LBCL. We followed the predefined protocol available at PROSPERO (CRD42023473854).

Results: We identified 41 studies evaluating the following interventions: non-CD19 CAR-T, CD19 CAR-T, bispecific antibodies (BiTEs), lenalidomide- and polatuzumab-based regimens, radiotherapy, immune checkpoint inhibitors (ICI), Bruton's Tyrosine Kinase inhibitors (BTKi). Non-CD19 CAR-T cells yielded the best CR (56%, CI: 40-71%), significantly higher than other interventions except CD19 CAR-T (CR = 30%, CI: 7-58%). BiTEs, radiotherapy, lenalidomide- and polatuzumab-based regimens (CR: 28%, 26%, 19%, 24% respectively) did not differ significantly from each other. ICI and BTKi showed the lowest CR rates (12%, CI: 5-20% and 8%, CI: 0-23%, respectively), and were also significantly inferior to BiTEs. ORR was the highest for non-CD19 CAR-T (ORR = 80%, CI: 66-92%), whereas all other regimens yielded values below 50%.

Conclusions: Non-CD19 CAR-T cells were associated with higher response rates and should be considered if patients are eligible. Given the heterogeneity of the estimates, the results should be interpreted cautiously.

Registration: PROSPERO CRD42023473854.

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来源期刊
Expert Opinion on Biological Therapy
Expert Opinion on Biological Therapy 医学-生物工程与应用微生物
CiteScore
8.60
自引率
0.00%
发文量
96
审稿时长
3-8 weeks
期刊介绍: Expert Opinion on Biological Therapy (1471-2598; 1744-7682) is a MEDLINE-indexed, international journal publishing peer-reviewed research across all aspects of biological therapy. Each article is structured to incorporate the author’s own expert opinion on the impact of the topic on research and clinical practice and the scope for future development. The audience consists of scientists and managers in the healthcare and biopharmaceutical industries and others closely involved in the development and application of biological therapies for the treatment of human disease. The journal welcomes: Reviews covering therapeutic antibodies and vaccines, peptides and proteins, gene therapies and gene transfer technologies, cell-based therapies and regenerative medicine Drug evaluations reviewing the clinical data on a particular biological agent Original research papers reporting the results of clinical investigations on biological agents and biotherapeutic-based studies with a strong link to clinical practice Comprehensive coverage in each review is complemented by the unique Expert Collection 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.
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