嵌合抗原受体 T 细胞治疗非霍奇金淋巴瘤患者的代谢肿瘤体积与生存：一项荟萃分析。
Metabolic tumor volume and the survival of patients with Non-Hodgkin lymphoma treated with chimeric antigen receptor T cell therapy: a meta-analysis.
机构信息
Department of Hematology, The Forth Affiliated Hospital of China Medical University, Shenyang, China.
Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China.
出版信息
Front Immunol. 2024 Aug 29;15:1433012. doi: 10.3389/fimmu.2024.1433012. eCollection 2024.
BACKGROUND
Chimeric antigen receptor T cell (CAR-T) is a promising treatment for aggressive Non-Hodgkin lymphoma (NHL). The aim of the meta-analysis was to determine the association between metabolic tumor volumes (MTV) derived on positron emission tomography before CAR-T infusion and the survival of patients with NHL.
METHODS
Relevant observational studies pertaining to the purpose of the meta-analysis were obtained through a search of PubMed, Web of Science, and Embase from inception of the databases to April 1, 2024. The data was combined using a random-effects model that accounted for the potential influence of between-study heterogeneity.
RESULTS
Fifteen observational studies were included. Pooled results showed that compared to those with a lower MTV, the NHL patients with a higher MTV before CAR-T infusion were associated with a poor progression-free survival (hazard ratio [HR]: 1.73, 95% confidence interval [CI]: 1.48 to 2.02, p < 0.001; I 20%) and overall survival (HR: 2.11, 95% CI: 1.54 to 2.89, p < 0.001; I 58%). Subgroup analysis showed that the association between MTV and survival of NHL patients after CAR-T was not significantly impacted by study design, methods for determination of MTV cutoff, or analytic models (univariate or multivariate, p for each subgroup all < 0.05). Subgroup analysis suggested a stronger association between MTV and poor survival outcomes in patients with median of lines of previous treatment of 2 or 3 as compared to those of 4 (p for subgroup difference < 0.05). Further meta-regression analyses suggested that the association between MTV and survival was not significantly affected by sample size, age, proportion of men, cutoff value of MTV, follow-up duration, or study quality scores (p all > 0.05).
CONCLUSION
A high MTV at baseline is associated with a poor survival of NHL patients after CAR-T.
SYSTEMATIC REVIEW REGISTRATION
https://inplasy.com/, identifier INPLASY (INPLASY202450069).
背景
嵌合抗原受体 T 细胞（CAR-T）是治疗侵袭性非霍奇金淋巴瘤（NHL）的一种有前途的方法。本荟萃分析的目的是确定 CAR-T 输注前正电子发射断层扫描（PET）上获得的代谢肿瘤体积（MTV）与 NHL 患者生存之间的关联。
方法
通过在 PubMed、Web of Science 和 Embase 数据库中从成立到 2024 年 4 月 1 日进行检索，获得了与荟萃分析目的相关的观察性研究。使用随机效应模型结合数据，该模型考虑了研究间异质性的潜在影响。
结果
纳入了 15 项观察性研究。汇总结果表明，与 MTV 较低的 NHL 患者相比，CAR-T 输注前 MTV 较高的 NHL 患者的无进展生存期（风险比[HR]：1.73，95%置信区间[CI]：1.48 至 2.02，p<0.001；I 20%）和总生存期（HR：2.11，95%CI：1.54 至 2.89，p<0.001；I 58%）较差。亚组分析表明，MTV 与 CAR-T 后 NHL 患者生存之间的关联不受研究设计、MTV 截止值确定方法或分析模型（单变量或多变量，p 对于每个亚组均<0.05）的影响。亚组分析表明，与 MTV 相比，与先前治疗中位数为 2 或 3 线的患者相比，与 MTV 相关的较差生存结果的相关性更强，而与先前治疗中位数为 4 线的患者相比（p 对于亚组差异<0.05）。进一步的元回归分析表明，MTV 与生存之间的关联不受样本量、年龄、男性比例、MTV 截止值、随访时间或研究质量评分的显著影响（p 均>0.05）。
结论
基线时 MTV 较高与 CAR-T 后 NHL 患者的生存较差相关。
系统评价注册
https://inplasy.com/，标识符 INPLASY（INPLASY202450069）。
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