Biotherapy Center, The Seventh Medical Center of PLA General Hospital, Beijing, China.
Biotherapy Center, The Seventh Medical Center of PLA General Hospital, Beijing, China.
Cytotherapy. 2019 Jul;21(7):769-781. doi: 10.1016/j.jcyt.2019.04.005. Epub 2019 May 31.
Immunotherapy with chimeric antigen receptor T (CAR-T) cells has proved remarkably effective in recently published clinical trials. In this meta-analysis, we performed a systematic review in terms of the clinical response treated with CAR-T cells in acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL) and lymphomas patients. Thirty-eight published clinical studies including 665 patients were eligible for response rate (RR) evaluation. The overall pooled RR of CD19-CAR-T cells was 72% (95% confidence interval: 62-77%). The various clinical parameters were analyzed. RR was 81% in ALL, 68% in lymphoma and 70% in CLL. RR in patients who received interleukin (IL)-2 was 70%, whereas in those who did not receive IL-2, it was 74%. RR was 75% with lymphodepletion and 56% without lymphodepletion. RR with autologous cells was 76% and 57% with allogeneic cells. In conclusion, this meta-analysis showed a high clinical RR of CD19-CAR-T cell-based immunotherapy in patients with refractory B-cell malignancies.
嵌合抗原受体 T (CAR-T) 细胞的免疫疗法在最近发表的临床试验中被证明具有显著疗效。在这项荟萃分析中，我们针对 CAR-T 细胞治疗急性淋巴细胞白血病 (ALL)、慢性淋巴细胞白血病 (CLL) 和淋巴瘤患者的临床反应进行了系统评价。38 项已发表的临床研究共纳入 665 例患者，适合进行缓解率 (RR) 评估。CD19-CAR-T 细胞的总体汇总 RR 为 72% (95%置信区间：62-77%)。分析了各种临床参数。ALL 的 RR 为 81%，淋巴瘤为 68%，CLL 为 70%。接受白细胞介素 (IL)-2 治疗的患者 RR 为 70%，而未接受 IL-2 治疗的患者 RR 为 74%。淋巴耗竭的 RR 为 75%，无淋巴耗竭的 RR 为 56%。自体细胞的 RR 为 76%，异基因细胞的 RR 为 57%。总之，这项荟萃分析表明，基于 CD19-CAR-T 细胞的免疫疗法在难治性 B 细胞恶性肿瘤患者中具有较高的临床 RR。
