在CAR T细胞治疗在复发性/耐药性大B细胞淋巴瘤中失败后获得临床试验准入
Kunhwa Kim1, Rahul Shah1, Amy Ayers2
1Division of Cancer Medicine, The University of Texas MD Anderson, Houston, Texas, USA.
British journal of haematology
|January 12, 2026
概括
许多患有复发性/耐药性大B细胞淋巴瘤 (LBCL) 的患者在CAR T细胞治疗后没有参加临床试验. 高风险特征和严格的试验标准限制了参与,突出了对更具包容性的研究的需求.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床试验 临床试验
背景情况:
- 复发性/耐药性大B细胞淋巴瘤 (r/r LBCL) 在CAR T细胞治疗后结果不佳.
- 对于在CAR T细胞治疗后进展的患者,治疗选择有限,临床试验入学率低.
研究的目的:
- 描述实践模式,并确定影响临床试验参与的因素r/r LBCL患者在CAR T细胞治疗后.
- 评估这些患者是否有资格参加现有临床试验.
主要方法:
- 单一中心对166名经过CAR T细胞治疗后进展的r/r LBCL患者进行研究 (2018年1月至2023年9月).
- 在查,入学和治疗阶段分析患者,疾病和临床特征.
- 根据新药关键试验的标准对患者的资格进行评估.
主要成果:
- 只有39%的患者接受了查,23%的患者被录取,22%的患者接受了试验治疗.
- 高风险特征 (例如,ECOG PS ≥2,第四阶段疾病,不完全反应) 与不参与有关.
- 14%-36%的患者有资格参加关键试验,这表明存在重大障碍.
结论:
- 在CAR T细胞治疗后,有大量未满足的临床试验需要适应高风险人群.
- 必须减少参与试验的障碍,以改善r/r LBCL患者的治疗结果.
- 开发包容性试验设计对于在CAR T细胞治疗失败后推进治疗选择至关重要.
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