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嵌合抗原受体T细胞疗法治疗胶质母细胞瘤的安全性和有效性:一项系统评价和荟萃分析

Safety and Efficacy of Chimeric Antigen Receptor T-Cell Therapy for Glioblastoma: A Systemic Review and Meta-Analysis.

作者信息

Jang Jong Keon, Pyo Junhee, Suh Chong Hyun, Park Hye Sun, Chae Young Kwang, Kim Kyung Won

机构信息

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Asan Medical Center, Department of Biomedical Engineering, College of Medicine, University of Ulsan, Seoul, South Korea.

出版信息

Front Oncol. 2022 May 26;12:851877. doi: 10.3389/fonc.2022.851877. eCollection 2022.

Abstract

BACKGROUND

Chimeric antigen receptor (CAR) T-cell therapy is a promising treatment option for patients with refractory hematological malignancies. However, its efficacy in glioblastoma remains unclear. Here, we performed a systematic review to summarize the safety and efficacy of CAR T-cell therapy in glioblastoma.

METHODS

The PubMed, EMBASE, and Cochrane databases were searched to identify articles published before June 30, 2021 describing the use of CAR T-cell therapy in glioblastoma. Information on the toxicity of CAR T-cell therapy was summarized. The pooled objective response rate (ORR) and overall survival (OS) of patients who underwent CAR T-cell therapy were estimated using a random-effects model with an inverse-variance weighting model and quantile estimation method, respectively.

RESULTS

Of 397 articles identified, eight studies including 63 patients with recurrent glioblastoma treated with various CAR T-cell regimens were included in the analysis. Six (9.5%) patients developed cytokine release syndrome (grade ≤2), and 16 (25.4%) experienced non-critical neurological events. The pooled ORR was 5.1% (95% confidence interval [CI], 0.0-10.4; = 0.05%), and the pooled median OS was 8.1 months (95% CI, 6.7-9.5; = 0.00%).

CONCLUSION

Although -cell therapy is a relatively safe therapeutic option in patients with glioblastoma, it shows marginal efficacy, suggesting that further research is necessary for its translation into clinical practice for the treatment of recurrent glioblastoma.

摘要

背景

嵌合抗原受体(CAR)T细胞疗法是难治性血液系统恶性肿瘤患者一种有前景的治疗选择。然而,其在胶质母细胞瘤中的疗效仍不明确。在此,我们进行了一项系统评价,以总结CAR T细胞疗法在胶质母细胞瘤中的安全性和疗效。

方法

检索PubMed、EMBASE和Cochrane数据库,以识别2021年6月30日前发表的描述CAR T细胞疗法在胶质母细胞瘤中应用的文章。总结了CAR T细胞疗法的毒性信息。分别使用具有逆方差加权模型和分位数估计方法的随机效应模型,估计接受CAR T细胞疗法患者的汇总客观缓解率(ORR)和总生存期(OS)。

结果

在识别出的397篇文章中,8项研究(包括63例接受各种CAR T细胞方案治疗的复发性胶质母细胞瘤患者)纳入分析。6例(9.5%)患者发生细胞因子释放综合征(≤2级),16例(25.4%)经历非严重神经系统事件。汇总ORR为5.1%(95%置信区间[CI],0.0 - 10.4;P = 0.05%),汇总中位OS为8.1个月(95%CI,6.7 - 9.5;P = 0.00%)。

结论

尽管CAR T细胞疗法在胶质母细胞瘤患者中是一种相对安全的治疗选择,但其疗效有限,这表明将其转化为复发性胶质母细胞瘤的临床治疗方法还需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1f6/9178287/1f1a698a5d26/fonc-12-851877-g001.jpg

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