在奇默抗原受体T细胞治疗后扩散的大B细胞淋巴瘤的治疗或复发
Mohamed A Kharfan-Dabaja1, Tea Reljic2, Razan Mohty3
1Division of Hematology-Oncology and Blood and Marrow Transplantation and Cellular Therapy program, Mayo Clinic, Jacksonville, FL, USA.
Transplantation and cellular therapy
|August 23, 2025
概括
在CAR T细胞治疗后进展的扩散性大B细胞淋巴瘤 (DLBCL) 中,全源造血细胞移植 (allo- HCT) 显示了最高的整体存活率. 对复发DLBCL的治疗选择需要仔细考虑患者和疾病因素.
科学领域:
- 癌症学
- 血液学
- 免疫疗法
背景情况:
- 在化学抗原受体T细胞 (CAR T细胞) 治疗后,扩散性大B细胞淋巴瘤 (DLBCL) 在进展或复发时缺乏标准治疗选择.
- 许多患者不符合临床试验的条件,因此需要对现有的不同疗效的治疗方法进行评估.
研究的目的:
- 在CAR T细胞治疗后复发或进展的DLBCL患者的不同治疗方法的有效性进行系统审查和元分析.
- 为了比较全源造血细胞移植 (allo- HCT),布鲁顿氨酸激酶抑制剂,双特异性药物,检查点抑制剂,化疗,基于莱纳利多米德的,基于波拉图祖马布的,基于辐射的,以及基于tafasitamab或loncastuximab的疗法.
主要方法:
- 对前性和后性研究进行系统审查和元分析.
- 纳入标准需要对复发性/ 耐药性DLBCL患者的特异治疗方案进行评估,并注册至少10名患者.
- 在PubMed和EMBASE上进行了搜索,研究质量使用修改后的纽卡斯尔-太华尺度进行了评估. 数据使用随机效应模型进行聚合.
主要成果:
- 这项分析包括951个已识别的参考研究中的24项研究.
- 聚合的客观反应率为alo- HCT的59%,以波拉图祖马布为基础的疗程的57%和双特异的51%.
- 异构造血细胞移植 (异构造血细胞移植) 的综合完全缓解率 (38%) 和整体存活率 (59%) 较高,复发率较低 (27%).
结论:
- 在CAR T细胞治疗后,复发性/ 耐药DLBCL的治疗决定是复杂的.
- 考虑患者的表现状况,疾病特征 (局部或全身),以及先前的治疗史至关重要.
- 这一系统性审查和元分析提供了各种疗法的有效性的证据.
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