CAR-T和blinatumumab免疫治疗作为复发/难治性B细胞急性淋巴细胞白血病桥接移植策略的疗效和安全性比较

IF 12.5 1区医学 Q1 ONCOLOGY

Cancer research Pub Date : 2025-04-22 DOI:10.1158/1538-7445.am2025-643

Wenyue Cao, Ningwen Li, Na Wang, Yang Cao

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引用次数: 0

摘要

背景：B细胞急性淋巴细胞白血病（B- all）尽管取得了进展，但仍然是一个治疗挑战。造血干细胞移植（HSCT）提供了一种潜在的治疗方法，但受到各种限制的阻碍。新兴的免疫疗法，包括嵌合抗原受体T细胞（CAR-T）疗法和Blinatumomab，已经显示出在复发/难治性（R/R）病例中作为HSCT桥接策略的潜力。方法：对同济医院2017年3月至2023年3月36例接受HSCT治疗的R/R B-ALL患者进行回顾性研究。移植前，27例患者接受了CD19/CD22 CAR-T治疗，9例患者接受了blinatumumab治疗。评估的结果包括总生存期（OS）、无进展生存期（PFS）、移植物抗宿主病和无复发生存期（GRFS）和非复发死亡率（NRM），并在治疗组之间进行比较。造血重建和移植相关并发症也进行了评估。结果：中位随访时间28.07个月，范围2.29 ~ 92.21个月。整个队列的2年OS、PFS、GRFS和NRM分别为76.54%、54.97%、40.12%和9.93%。移植前CAR-T治疗组和blinatumumab治疗组2年OS分别为73.89%和88.89% (P=0.862)， PFS分别为59.03%和44.44% (P=0.501)， GRFS分别为47.86%和13.89% (P=0.083)， NRM分别为8.52%和11.11% （P=0.713）。CAR-T和blinatumab两组的安全性相似，在造血重建、感染、II-IV级急性移植物抗宿主病（GVHD）和慢性GVHD发生率方面没有显著差异。结论：CAR-T和blinatumumab疗法在R/R B-ALL患者中作为HSCT桥接治疗具有相当的安全性和有效性。需要进一步的研究来优化这些治疗策略。引用格式：曹文跃，李宁文，王娜，曹阳。CAR-T和blinatumab免疫治疗作为复发/难治性B细胞急性淋巴细胞白血病桥接移植策略的疗效和安全性比较[摘要]。摘自：《2025年美国癌症研究协会年会论文集》；第一部分（常规摘要）；2025年4月25日至30日；费城（PA）： AACR；癌症杂志，2025;85(8_Suppl_1)：摘要第643期。

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Abstract 643: Efficacy and safety comparison of CAR-T and blinatumomab immunotherapy as bridge-to-transplant strategy in relapsed/refractory B cell acute lymphoblastic leukemia

Background: B cell acute lymphoblastic leukemia (B-ALL) remains a therapeutic challenge despite advances. Hematopoietic stem cell transplantation (HSCT) provides a potential cure but is hindered by various limitations. Emerging immunotherapies, including chimeric antigen receptor T cell (CAR-T) therapy and Blinatumomab, have shown potential as bridging strategies to HSCT in relapsed/refractory (R/R) cases. Methods: A retrospective study was conducted at Tongji Hospital from March 2017 to March 2023, involving 36 R/R B-ALL patients who underwent HSCT. Prior to transplantation, 27 patients received CD19/CD22 CAR-T therapy, while 9 received Blinatumomab. Outcomes assessed included the overall survival (OS), progression-free survival (PFS), graft-versus-host disease-free and relapse-free survival (GRFS), and non-relapse mortality (NRM), with comparisons made between treatment groups. Hematopoietic reconstitution and transplant-related complications were also evaluated. Results: The median follow-up time was 28.07 (range: 2.29-92.21) months. The 2-year OS, PFS, GRFS, and NRM of the entire cohort were 76.54%, 54.97%, 40.12%, and 9.93%, respectively. In the CAR-T and the Blinatumomab treatment group before transplantation, the 2-year OS was 73.89% and 88.89% (P=0.862), PFS, was 59.03% and 44.44% (P=0.501), GRFS was 47.86% and 13.89% (P=0.083), and NRM was 8.52% and 11.11% (P=0.713), respectively. Safety profiles were similar with no significant differences observed in hematopoietic reconstitution, infection, the incidence of grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD incidence between CAR-T and Blinatumomab groups. Conclusion: CAR-T and Blinatumomab therapies demonstrate comparable safety and efficacy as bridging treatments to HSCT in patients with R/R B-ALL. Further studies are needed to optimize these treatment strategies. Citation Format: Wenyue Cao, Ningwen Li, Na Wang, Yang Cao. Efficacy and safety comparison of CAR-T and blinatumomab immunotherapy as bridge-to-transplant strategy in relapsed/refractory B cell acute lymphoblastic leukemia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 643.

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来源期刊

Cancer research 医学-肿瘤学

CiteScore

16.10

自引率

0.90%

发文量

7677

审稿时长

2.5 months

期刊介绍： Cancer Research, published by the American Association for Cancer Research (AACR), is a journal that focuses on impactful original studies, reviews, and opinion pieces relevant to the broad cancer research community. Manuscripts that present conceptual or technological advances leading to insights into cancer biology are particularly sought after. The journal also places emphasis on convergence science, which involves bridging multiple distinct areas of cancer research. With primary subsections including Cancer Biology, Cancer Immunology, Cancer Metabolism and Molecular Mechanisms, Translational Cancer Biology, Cancer Landscapes, and Convergence Science, Cancer Research has a comprehensive scope. It is published twice a month and has one volume per year, with a print ISSN of 0008-5472 and an online ISSN of 1538-7445. Cancer Research is abstracted and/or indexed in various databases and platforms, including BIOSIS Previews (R) Database, MEDLINE, Current Contents/Life Sciences, Current Contents/Clinical Medicine, Science Citation Index, Scopus, and Web of Science.