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针对复发/难治性 CD30+淋巴瘤的 CD30 导向嵌合抗原受体 T 细胞的患者报告结局。

Patient-reported outcomes in CD30-directed CAR-T cells against relapsed/refractory CD30+ lymphomas.

机构信息

Medical Oncology Service, National Institutes of Health, Bethesda, Maryland, USA.

Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

出版信息

J Immunother Cancer. 2023 Aug;11(8). doi: 10.1136/jitc-2023-006959.

Abstract

Chimeric antigen receptor (CAR)-T cells targeting CD30 have demonstrated high response rates with durable remissions observed in a subset of patients with relapsed/refractory CD30+ hematologic malignancies, particularly classical Hodgkin lymphoma. This therapy has low rates of toxicity including cytokine release syndrome with no neurotoxicity observed in our phase 2 study. We collected patient-reported outcomes (PROs) on patients treated with CD30 directed CAR-T cells to evaluate the impact of this therapy on their symptom experience. We collected PROs including PROMIS (Patient-Reported Outcomes Measurement Information System) Global Health and Physical Function questionnaires and selected symptom questions from the NCI PRO-CTCAE in patients enrolled on our clinical trial of CD30-directed CAR-T cells at procurement, at time of CAR-T cell infusion, and at various time points post treatment. We compared PROMIS scores and overall symptom burden between pre-procurement, time of infusion, and at 4 weeks post infusion. At least one PRO measurement during the study period was found in 23 out of the 28 enrolled patients. Patient overall symptom burden, global health and mental health, and physical function were at or above baseline levels at 4 weeks post CAR-T cell infusion. In addition, PROMIS scores for patients who participated in the clinical trial were similar to the average healthy population. CD30 CAR-T cell therapy has a favorable toxicity profile with patient physical function and symptom burden recovering to at least their baseline pretreatment health by 1 month post infusion. Trial registration number: NCT02690545.

摘要

嵌合抗原受体 (CAR)-T 细胞靶向 CD30,在复发/难治性 CD30+血液恶性肿瘤患者亚组中观察到高缓解率和持久缓解,尤其是经典霍奇金淋巴瘤。这种治疗方法毒性较低,包括细胞因子释放综合征,但在我们的 2 期研究中未观察到神经毒性。我们收集了接受 CD30 定向 CAR-T 细胞治疗的患者的患者报告结局 (PRO),以评估该治疗对其症状体验的影响。我们收集了 PRO,包括 PROMIS(患者报告结局测量信息系统)总体健康和身体功能问卷,以及从 NCI PRO-CTCAE 中选择的与我们的 CD30 定向 CAR-T 细胞临床试验中入组患者的症状相关问题。我们比较了采集时、CAR-T 细胞输注时和治疗后不同时间点的 PROMIS 评分和总体症状负担。在研究期间,至少有一个 PRO 测量在 28 名入组患者中的 23 名中找到。CAR-T 细胞输注后 4 周时,患者的整体症状负担、总体健康和心理健康以及身体功能均达到或高于基线水平。此外,参加临床试验的患者的 PROMIS 评分与普通健康人群相似。CD30 CAR-T 细胞治疗具有良好的毒性特征,患者的身体功能和症状负担在输注后 1 个月至少恢复到基线治疗前的健康水平。试验注册号:NCT02690545。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56c/10394544/b9dddb8abcbf/jitc-2023-006959f01.jpg

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