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Published on: February 17, 2022
CAR-T Cell Therapy Versus Salvage Chemotherapy in Relapsed/Refractory DLBCL: A Systematic Review and Meta-Analysis
Fatma M Elsayed1, Juman Baban2, Heba Yahia Elkholy3
1Department of Internal Medicine, Hematology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
La Clinica Terapeutica
|June 24, 2026
Summary
Chimeric antigen receptor T-cell (CAR-T) therapy significantly improves survival and response rates for relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) compared to salvage chemotherapy. CAR-T therapy is particularly beneficial for high-risk patients.
Area of Science:
- Hematology
- Oncology
- Immunotherapy
Background:
- Relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) presents significant treatment challenges.
- Chimeric antigen receptor T-cell (CAR-T) therapy is a promising option, but its effectiveness versus salvage chemotherapy needs evaluation.
Purpose of the Study:
- To systematically review and meta-analyze the comparative effectiveness of CAR-T therapy versus salvage chemotherapy in adult patients with R/R DLBCL.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA 2020 and MOOSE guidelines.
- Inclusion of randomized controlled trials and high-quality comparative cohort studies.
- Analysis of overall survival (OS), progression-free survival (PFS), complete metabolic response (CMR), and toxicity profiles.
Main Results:
- CAR-T therapy significantly improved PFS (HR 0.55) and OS (HR 0.68) compared to salvage chemotherapy.
- Higher complete metabolic response rates were observed with CAR-T therapy (56.0%) versus salvage chemotherapy (24.5%).
- CAR-T therapy showed specific toxicities (CRS, ICANS), while salvage chemotherapy had higher hematologic toxicity rates.
Conclusions:
- CAR-T therapy offers superior survival and response outcomes for R/R DLBCL patients, especially those with high-risk features.
- Integrating predictive biomarkers can optimize patient selection and toxicity management for CAR-T therapy.