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抗 CD19/CD22、抗 CD19 和抗 CD22 CAR-T 治疗成人复发/难治性 B 细胞急性淋巴细胞白血病的疗效和安全性差异:一项荟萃分析和系统评价。

Differences in efficacy and safety among CAR-Ts anti-CD19/CD22, anti-CD19, and anti-CD22, in adult patients with relapse/refractory B-cell acute lymphoblastic leukemia: a meta-analysis and systematic review.

机构信息

Subdirección de investigación Básica, Instituto Nacional de Cancerología, Secretaría de Salud, Ciudad de México, México.

Programa de posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Ciudad de México, México.

出版信息

Leuk Lymphoma. 2023 Nov-Dec;64(11):1822-1831. doi: 10.1080/10428194.2023.2243357. Epub 2023 Aug 7.

Abstract

Relapsed/refractory B-cell acute lymphoblastic leukemia (R/R B-ALL) is a challenging disease with low rates of remission and survival in adult patients. Anti-CD19 Chimeric Antigen Receptor T-cells (CAR-Ts) therapies have been approved for these patients. Dual-target CAR-Ts against CD19 and CD22 have recently been developed to improve the efficacy of the single-target therapy; however, extent of the improvement using this dual-target therapy has yet to be determined. We performed a meta-analysis of the outcome and safety of CAR-Ts, comparing anti-CD19 vs anti-CD22 vs dual-target anti-CD19/CD22 CAR-Ts, to elucidate the differences and limitations of these therapies in adult patients with R/R B-ALL. our results suggest that anti-CD19/CD22 CAR-Ts generate lower incidence of relapse and neurotoxicity, but similar results were obtained regarding complete remission, minimal residual disease, overall survival, and cytokine release syndrome compared with single-target anti-CD19 and anti-CD22 CAR-Ts.

摘要

复发/难治性 B 细胞急性淋巴细胞白血病(R/R B-ALL)是一种具有挑战性的疾病,成人患者的缓解率和生存率较低。抗 CD19 嵌合抗原受体 T 细胞(CAR-T)疗法已被批准用于这些患者。最近开发了针对 CD19 和 CD22 的双靶点 CAR-T 以提高单靶点治疗的疗效;然而,使用这种双靶点治疗的改善程度尚待确定。我们对 CAR-T 的结果和安全性进行了荟萃分析,比较了抗 CD19 与抗 CD22 与双靶点抗 CD19/CD22 CAR-T,以阐明这些疗法在 R/R B-ALL 成年患者中的差异和局限性。我们的结果表明,抗 CD19/CD22 CAR-T 引起的复发和神经毒性发生率较低,但与单靶点抗 CD19 和抗 CD22 CAR-T 相比,完全缓解、微小残留病、总生存率和细胞因子释放综合征的结果相似。

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