Lemoine Jean, Vic Samuel, Houot Roch
AP-HP, Department of Hematology, Université de Paris, Paris, France.
Department of Hematology, CHU de Rennes, Université de Rennes, Rennes, France.
Eur J Cancer. 2022 Jan;160:235-242. doi: 10.1016/j.ejca.2021.10.022. Epub 2021 Dec 2.
We compared outcomes of patients with B-cell malignancies treated in clinical trials with the same CD19 chimeric antigen receptor (CAR) T-cells across different indications, including B-cell acute lymphoblastic leukaemia (B-ALL), diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL) and follicular lymphoma (FL). We found that for a given CAR T-cell, efficacy and toxicity varied depending on the disease. Overall, we found a low rate of primary resistance in FL, MCL and B-ALL compared with DLBCL. Acute toxicities (cytokine release syndrome and ICANS) appeared to be significantly less severe in FL compared with more aggressive diseases, such as B-ALL, DLBCL and MCL. These observations suggest that each B-cell malignancy harbours specific biology, which may interact differently with CAR T-cell therapy. Thus, CAR T-cells may be tailored differently depending on the type of B-cell malignancy to optimise their efficacy and safety.
我们比较了在临床试验中接受相同CD19嵌合抗原受体（CAR）T细胞治疗的B细胞恶性肿瘤患者在不同适应症中的治疗结果，这些适应症包括B细胞急性淋巴细胞白血病（B-ALL）、弥漫性大B细胞淋巴瘤（DLBCL）、套细胞淋巴瘤（MCL）和滤泡性淋巴瘤（FL）。我们发现，对于给定的CAR T细胞，疗效和毒性因疾病而异。总体而言，我们发现与DLBCL相比，FL、MCL和B-ALL的原发性耐药率较低。与B-ALL、DLBCL和MCL等侵袭性更强的疾病相比，FL的急性毒性（细胞因子释放综合征和免疫效应细胞相关神经毒性综合征）似乎明显较轻。这些观察结果表明，每种B细胞恶性肿瘤都具有特定的生物学特性，其与CAR T细胞疗法的相互作用可能不同。因此，根据B细胞恶性肿瘤的类型，CAR T细胞的定制方式可能会有所不同，以优化其疗效和安全性。
