Department of Biomedicine & Health Sciences, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Preventive Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Sci Rep. 2024 Oct 28;14(1):25752. doi: 10.1038/s41598-024-77210-2.
Few studies evaluated patient-reported outcomes (PROs) for patients with hematologic malignancies receiving with Chimeric Antigen Receptor T (CAR-T) cell therapy. We performed a systematic review and meta-analysis to evaluate the benefits of CAR-T cell therapies focused on PROs. A systematic literature searched from PubMed, Cochrane, and the Web of Science from inception to September 2023. Study selection and data extraction were conducted independently by two reviewers based on pre-specified criteria. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist was used to evaluate the methodological quality of the included studies. The random-effects model was employed to calculate the combined effect and 95% Confidence intervals. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and the protocol was registered with PROSPERO (CRD42024586706). We identified 20,110 studies. Of those, 15 studies with 16 different PRO measures (PROMs) were included in the meta-analysis. CAR-T cell therapy improved PROs in the six domains of general health status, pain, fatigue, depression, social function, and cognitive function: from the general health status (SMD: 0.57, 95% CI: 0.34 to 0.81) to cognitive function (SMD: 0.25, 95% CI: 0.14 to 0.37). The current meta-analysis shows that CAR-T cell therapy produces clinically meaningful differences in PROs. These results suggest that the professional perspective and patient values and preferences should be weighed equally when considering CAR-T cell therapy for hematologic malignancies.
很少有研究评估接受嵌合抗原受体 T（CAR-T）细胞治疗的血液系统恶性肿瘤患者的患者报告结局（PRO）。我们进行了一项系统评价和荟萃分析，以评估专注于 PRO 的 CAR-T 细胞疗法的益处。从 PubMed、Cochrane 和 Web of Science 系统地检索了从成立到 2023 年 9 月的文献。两名评审员根据预先确定的标准独立进行研究选择和数据提取。使用共识基于标准的健康测量仪器选择（COSMIN）偏倚风险清单评估纳入研究的方法学质量。采用随机效应模型计算合并效应和 95%置信区间。这项研究是按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行的，该方案已在 PROSPERO（CRD42024586706）中注册。我们确定了 20,110 项研究。其中，有 15 项研究包含 16 种不同的患者报告结局（PROM）测量方法，纳入荟萃分析。CAR-T 细胞疗法在一般健康状况、疼痛、疲劳、抑郁、社会功能和认知功能这六个领域改善了 PRO：从一般健康状况（SMD：0.57，95%CI：0.34 至 0.81）到认知功能（SMD：0.25，95%CI：0.14 至 0.37）。目前的荟萃分析表明，CAR-T 细胞疗法在 PRO 方面产生了具有临床意义的差异。这些结果表明，在考虑血液系统恶性肿瘤的 CAR-T 细胞治疗时，应该平等权衡专业观点和患者的价值观和偏好。
