CD7嵌合抗原受体T细胞疗法治疗血液系统恶性肿瘤的疗效与安全性：一项系统评价与荟萃分析

The efficacy and safety of CD7 chimeric antigen receptor T-cell therapy for hematologic malignancies: a systematic review and meta-analysis.

作者信息

Liu Jile, An Yuxin, Sun Rui, Zhang Xiaomei, Guo Shujing, Gao Xuejin, Zhao Mingfeng

机构信息

First Center Clinical College, Tianjin Medical University, Tianjin, China.

Nankai University School of Medicine, Nankai University, Tianjin, China.

出版信息

Front Oncol. 2025 Jan 7;14:1478888. doi: 10.3389/fonc.2024.1478888. eCollection 2024.

INTRODUCTION

CD7 chimeric antigen receptor T-cell (CAR-T cell) therapy is an emerging method for treating hematological malignancies, and is another breakthrough in CAR-T cell therapy.

METHODS

This study summarizes the currently published clinical research results on CD7 CAR-T cells and evaluates the safety and effectiveness of CD7 CAR-T cell therapy.

RESULTS

Among the 13 studies included in this study, a total of 200 patients received CD7 CAR-T cell therapy, including 88 patients who received autologous CAR-T cells, 112 patients who received donor derived CAR-T cells. 87% (80% -94%, =29.65%) of patients achieved complete remission. The incidence of cytokine release syndrome (CRS) was 94% (88% -98%, =32.71%, p=0.12), while the incidence of severe CRS (grade ≥ 3) was 12% (5% -20%, =41.04%, p=0.06). As for the incidence of immune effector cell-associated neurotoxicity syndrome (ICANS), it is 4% (1% -7%, =0, p=0.72). Through analysis of the key clinical issues, we found that consolidation allogeneic hematopoietic stem cell transplantation (allo-HSCT) after CAR-T cell therapy can significantly improve survival and avoid recurrence. Therefore, we believe that the consolidation allo-HSCT after CD7 CAR-T cell therapy should be advocated. And patients who received CD7 CAR-T cell therapy without gene editing had significantly longer overall survival than those who received CD7 CAR-T cell therapy with gene editing. This suggests that gene edited CD7 CAR-T cells may pose some potential risks that limit the long-term survival of patients.

CONCLUSION

Our study confirms the efficacy and safety of CD7 CAR-T cells and provides research directions for the subsequent treatment.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=502896, identifier CRD42024502896.

引言

CD7嵌合抗原受体T细胞（CAR-T细胞）疗法是一种治疗血液系统恶性肿瘤的新兴方法，是CAR-T细胞疗法的又一突破。

方法

本研究总结了目前已发表的关于CD7 CAR-T细胞的临床研究结果，并评估了CD7 CAR-T细胞疗法的安全性和有效性。

结果

本研究纳入的13项研究中，共有200例患者接受了CD7 CAR-T细胞疗法，其中88例接受了自体CAR-T细胞，112例接受了供体来源的CAR-T细胞。87%（80%-94%， =29.65%）的患者实现了完全缓解。细胞因子释放综合征（CRS）的发生率为94%（88%-98%， =32.71%，p=0.12），而严重CRS（≥3级）的发生率为12%（5%-20%， =41.04%，p=0.06）。至于免疫效应细胞相关神经毒性综合征（ICANS）的发生率，为4%（1%-7%， =0，p=0.72）。通过对关键临床问题的分析，我们发现CAR-T细胞疗法后进行巩固性异基因造血干细胞移植（allo-HSCT）可显著提高生存率并避免复发。因此，我们认为应提倡CD7 CAR-T细胞疗法后进行巩固性allo-HSCT。并且未接受基因编辑的CD7 CAR-T细胞疗法患者的总生存期明显长于接受基因编辑的CD7 CAR-T细胞疗法患者。这表明基因编辑的CD7 CAR-T细胞可能存在一些潜在风险，限制了患者的长期生存。