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Chimeric Antigen Receptor T-cell (CAR T) Therapy for Hematologic and Solid Malignancies: Efficacy and Safety—A Systematic Review with Meta-Analysis

机译:血液和固体恶性肿瘤的嵌合抗原受体T细胞(CAR T)治疗:疗效和安全性—荟萃分析的系统评价

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摘要

Chimeric antigen receptors T cells (CAR T) had been used for treating various tumor patients in clinic, and owned an incredible efficacy in part of malignancies. However, CAR T therapy remains controversial due to doubts about its efficacy and safety in the clinical treatment of various malignancies. A total of 997 tumor patients from 52 studies were included in this review. Eligible studies were searched and reviewed from the databases of PubMed, Web of Science, Wanfang and Clinicaltrials.gov. Then meta-analysis and subgroup analysis were used to investigate the overall response rate (ORR), complete response rate (CRR), common side effect rate (CSER) and relapse rate (RR) of CAR T therapy for patients in clinical researches, respectively. The results further confirmed that CAR T therapy had a higher response rate for hematologic malignancies. More importantly, CAR T therapy had a higher CSER in patients with hematologic malignancies, and it had a similar RR in patients with different malignancies. Cell cultured without the addition of IL-2 and total administration less than 108 cells were recommended. This study offers a reference for future research regarding the application in solid and hematologic malignancies, side effects and relapse, and even the production processes of CAR T cells.
机译:嵌合抗原受体T细胞(CAR T)已在临床上用于治疗各种肿瘤患者,并且在部分恶性肿瘤中具有令人难以置信的功效。然而,由于对CAR T疗法在各种恶性肿瘤的临床治疗中的功效和安全性的怀疑,仍然引起争议。该评价纳入了来自52项研究的997名肿瘤患者。从PubMed,Web of Science,Wanfang和Clinicaltrials.gov的数据库中搜索并审查了合格的研究。然后采用荟萃分析和亚组分析分别研究临床研究中CAR T治疗的总体缓解率(ORR),完全缓解率(CRR),常见副作用(CSER)和复发率(RR)。 。结果进一步证实,CAR T疗法对血液系统恶性肿瘤的响应率更高。更重要的是,CAR T治疗在血液系统恶性肿瘤患者中的CSER较高,而在不同恶性肿瘤患者中的RR相似。建议在不添加IL-2的情况下培养细胞,并且总给药量应少于10 8 个细胞。这项研究为以后在固体和血液系统恶性肿瘤中的应用,副作用和复发乃至CAR T细胞的生产过程提供了参考。

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