美国食品和药物管理局批准摘要:Ciltacabtagene Autoleucel用于复发性或耐火性多发性髓瘤
Kavita Natrajan1, Megha Kaushal1, Bindu George1
1Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland.
概括
一种CAR T细胞疗法Ciltacabtagene autoleucel在复发性/耐药性多发性髓瘤中显示出高响应率. 这种治疗证明了显著的疗效,在第二阶段试验中,总体应答率为97.9%.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 血液学 血液学 血液学
背景情况:
- 多发性骨髓瘤是一种血液性恶性瘤,其特征是不受控制的血细胞增殖.
- 复发性/耐药性多发性骨髓瘤带来了重大治疗挑战,需要新的治疗方法.
- 化学抗原受体 (CAR) T细胞疗法已成为血液恶性瘤的有希望的策略.
研究的目的:
- 评估ciltacabtagene autoleucel在患有复发/耐药多发性髓瘤的成年患者中的疗效和安全性.
- 为了评估整体反应率 (ORR),完整反应率 (CR) 和ciltacabtagene autoleucel的反应持续时间 (DoR).
- 描述与ciltacabtagene自动治疗相关的不良事件.
主要方法:
- 进行了一项单臂,开放标签,多中心的第二阶段试验 (CARTITUDE-1).
- 97名患有复发性/耐药性多发性骨髓瘤的成年患者接受了单次输注的ciltacabtagene autoleucel,用于淋巴切除后的化疗.
- 疗效终点包括ORR,CR率和DoR;安全性通过不良事件监测进行评估.
主要成果:
- 在可评估的患者中,Ciltacabtagene自动测试实现了高ORR的97.9% (95% CI,92.7-99.7).
- 观察到一个严格的CR率为78.4% (95% CI,68.8-86.1).
- 响应者的中位数DoR为21.8个月,随访时间中位数为18个月. 55%的患者出现严重不良反应,包括3级+细胞因子释放综合征 (5%) 和神经毒性 (11%).
结论:
- Ciltacabtagene自杀药在重度预治疗复发性/耐药性多发性骨髓瘤患者中显示出相当大的疗效.
- 观察到的响应率和响应持续时间支持其作为治疗选择的作用.
- 仔细监测不良事件,包括细胞因子释放综合征和神经毒性,对于使用这种CAR T细胞疗法治疗的患者的管理至关重要.
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