CAR-T 细胞治疗下淋巴瘤患者 F-FDG PET 参数的预后效用：系统评价和荟萃分析。
The prognostic utility of F-FDG PET parameters in lymphoma patients under CAR-T-cell therapy: a systematic review and meta-analysis.
机构信息
Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Amman, Jordan.
School of Medicine, The University of Jordan, Amman, Jordan.
出版信息
Front Immunol. 2024 Sep 2;15:1424269. doi: 10.3389/fimmu.2024.1424269. eCollection 2024.
BACKGROUND
Chimeric antigen receptor (CAR) T-cell therapy has attracted considerable attention since its recent endorsement by the Food and Drug Administration, as it has emerged as a promising immunotherapeutic modality within the landscape of oncology. This study explores the prognostic utility of [F]Fluorodeoxyglucose positron emission tomography ([F]FDG PET) in lymphoma patients undergoing CAR T-cell therapy. Through meta-analysis, pooled hazard ratio (HR) values were calculated for specific PET metrics in this context.
METHODS
PubMed, Scopus, and Ovid databases were explored to search for relevant topics. Dataset retrieval from inception until March 12, 2024, was carried out. The primary endpoints were impact of specific PET metrics on overall survival (OS) and progression-free survival (PFS) before and after treatment. Data from the studies were extracted for a meta-analysis using Stata 17.0.
RESULTS
Out of 27 studies identified for systematic review, 15 met the criteria for meta-analysis. Baseline OS analysis showed that total metabolic tumor volume (TMTV) had the highest HR of 2.66 (95% CI: 1.52-4.66), followed by Total-body total lesion glycolysis (TTLG) at 2.45 (95% CI: 0.98-6.08), and maximum standardized uptake values (SUVmax) at 1.30 (95% CI: 0.77-2.19). TMTV and TTLG were statistically significant ( < 0.0001), whereas SUVmax was not ( = 0.33). For PFS, TMTV again showed the highest HR at 2.65 (95% CI: 1.63-4.30), with TTLG at 2.35 (95% CI: 1.40-3.93), and SUVmax at 1.48 (95% CI: 1.08-2.04), all statistically significant ( ≤ 0.01). The ΔSUVmax was a significant predictor for PFS with an HR of 2.05 (95% CI: 1.13-3.69, = 0.015).
CONCLUSION
[F]FDG PET parameters are valuable prognostic tools for predicting outcome of lymphoma patients undergoing CAR T-cell therapy.
背景
嵌合抗原受体 (CAR) T 细胞疗法自获得美国食品和药物管理局批准以来备受关注，因为它已成为肿瘤学领域中一种很有前途的免疫治疗方式。本研究探讨了氟代脱氧葡萄糖正电子发射断层扫描 ([F]FDG PET) 在接受 CAR T 细胞治疗的淋巴瘤患者中的预后作用。通过荟萃分析，计算了该背景下特定 PET 指标的合并风险比 (HR) 值。
方法
通过检索 PubMed、Scopus 和 Ovid 数据库，探讨了相关主题。从成立到 2024 年 3 月 12 日，进行了数据集检索。主要终点是特定 PET 指标在治疗前后对总生存期 (OS) 和无进展生存期 (PFS) 的影响。使用 Stata 17.0 从研究中提取数据进行荟萃分析。
结果
系统评价中确定了 27 项研究，其中 15 项符合荟萃分析标准。基线 OS 分析显示，总代谢肿瘤体积 (TMTV) 的 HR 最高，为 2.66(95%CI：1.52-4.66)，其次是全身总病变糖酵解 (TTLG)，为 2.45(95%CI：0.98-6.08)，最大标准化摄取值 (SUVmax)为 1.30(95%CI：0.77-2.19)。TMTV 和 TTLG 具有统计学意义( < 0.0001)，而 SUVmax 则无统计学意义( = 0.33)。对于 PFS，TMTV 再次显示出最高的 HR 为 2.65(95%CI：1.63-4.30)，TTLG 为 2.35(95%CI：1.40-3.93)，SUVmax 为 1.48(95%CI：1.08-2.04)，均具有统计学意义(≤0.01)。ΔSUVmax 是 PFS 的一个显著预测因子，HR 为 2.05(95%CI：1.13-3.69， = 0.015)。
结论
[F]FDG PET 参数是预测接受 CAR T 细胞治疗的淋巴瘤患者结局的有价值的预后工具。
Zotero 插件