Division of Hematology Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Division of Hematology Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Transplant Cell Ther. 2024 Feb;30(2):131-142. doi: 10.1016/j.jtct.2023.11.008. Epub 2023 Nov 10.
The first series of chimeric antigen receptor T (CAR-T) cell therapy products were approved in 2017 to 2019 and have shown remarkable efficacy in both clinical trials and the real-world setting, but at the cost of prolonged patient hospitalization. As the toxicity management protocols were refined, the concept of cellular therapy administered in the outpatient setting gained steam, and single institutions began to perform certain aspects of CAR-T monitoring in the outpatient setting for select patients. However, there are many considerations for a successful outpatient program. In anticipation of increasing use of CAR-T-cell therapy in the outpatient setting as a mechanism to overcome frequent hospital bed shortages and high cost of inpatient care, the American Society for Transplantation and Cellular Therapy convened a group of experts in hematology, oncology, and cellular therapy to provide a comprehensive review of the existing publications on outpatient CAR-T cell therapy, discuss selected ongoing clinical trials of outpatient CAR-T, and describe strategies to optimize safety without compromising efficacy for patients treated and monitored in the outpatient setting.
首批嵌合抗原受体 T（CAR-T）细胞疗法产品于 2017 年至 2019 年获得批准，在临床试验和真实世界环境中均显示出显著疗效，但患者住院时间延长。随着毒性管理方案的完善，门诊环境下进行细胞疗法的概念逐渐流行起来，一些单家机构开始为选定的患者在门诊环境下进行某些 CAR-T 监测。然而，要成功开展门诊项目需要考虑诸多因素。为了增加在门诊环境中使用 CAR-T 细胞疗法作为克服频繁病床短缺和住院治疗高成本的机制的预期，美国移植和细胞治疗学会召集了一组血液学、肿瘤学和细胞治疗领域的专家，对门诊 CAR-T 细胞疗法的现有文献进行全面回顾，讨论正在进行的门诊 CAR-T 临床试验，并描述在不影响疗效的情况下优化安全性的策略，以便为门诊环境下接受治疗和监测的患者提供服务。
