Efficacy and safety of chimeric antigen receptor-T cells in the treatment of B cell lymphoma: a systematic review and meta-analysis
Identifieur interne : 000409 ( Main/Exploration ); précédent : 000408; suivant : 000410Efficacy and safety of chimeric antigen receptor-T cells in the treatment of B cell lymphoma: a systematic review and meta-analysis
Auteurs : Xiao-Hong Zheng [République populaire de Chine] ; Xi-You Zhang [République populaire de Chine] ; Qian-Qian Dong [République populaire de Chine] ; Feng Chen [République populaire de Chine] ; Shou-Bo Yang [République populaire de Chine] ; Wen-Bin Li [République populaire de Chine]Source :
- Chinese Medical Journal [ 0366-6999 ] ; 2020.
Abstract
Conventional treatment has limited efficacy in relapsed/refractory B-cell lymphoma. Since chimeric antigen receptor T-cell (CAR-T) technology has shown high safety and results in high remission rates, we investigated its efficacy and safety in B-cell lymphoma treatment and analyzed potential affecting factors to provide evidence for therapeutic strategies and applications.
We searched databases including PubMed, Embase, and Cochrane up to July 2019. Meta-analysis 1 was conducted to study the efficacy of CAR-T cell for treating B-cell lymphoma, measuring the response rate and complete remission rate as outcomes. Sub-group analysis was performed for age, pathological type, target antigen, co-stimulatory molecule, and conditioning chemotherapy. Meta-analysis 2 was undertaken on the safety of the treatment with the incidence rate of toxicity (cytokine-releasing syndrome [CRS], neurotoxicity) as an outcome.
Seventeen studies were included in the systematic review and meta-analysis. It was found that CAR-T cells had good therapeutic effects in the following cases: B-cell lymphoma (patients ≥65 years old); diffuse large B-cell lymphoma pathological type; patients with treatment target antigen other than CD19; patients treated with co-stimulatory molecules other than CD28, including 4-1BB+CD28 or 4-1BB; and patients treated with cyclophosphamide/fludarabine pre-treatment protocol conditioning chemotherapy. Although the CRS and neurotoxicity incidences were high, most were reversible with minimal risk of death.
CAR-T cell treatment is safe for clinical application; however, toxicity effects should be monitored.
Url:
DOI: 10.1097/CM9.0000000000000568
PubMed: 31923107
PubMed Central: 7028209
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Efficacy and safety of chimeric antigen receptor-T cells in the treatment of B cell lymphoma: a systematic review and meta-analysis</title><author><name sortKey="Zheng, Xiao Hong" sort="Zheng, Xiao Hong" uniqKey="Zheng X" first="Xiao-Hong" last="Zheng">Xiao-Hong Zheng</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Zhang, Xi You" sort="Zhang, Xi You" uniqKey="Zhang X" first="Xi-You" last="Zhang">Xi-You Zhang</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Dong, Qian Qian" sort="Dong, Qian Qian" uniqKey="Dong Q" first="Qian-Qian" last="Dong">Qian-Qian Dong</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of General Medicine, Ningbo Medical Center, Li Huili Hospital, Ningbo, Zhejiang 315000, China.</nlm:aff><country xml:lang="fr" wicri:curation="lc">République populaire de Chine</country><wicri:regionArea>Department of General Medicine, Ningbo Medical Center, Li Huili Hospital, Ningbo, Zhejiang 315000</wicri:regionArea><wicri:noRegion>Zhejiang 315000</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Feng" sort="Chen, Feng" uniqKey="Chen F" first="Feng" last="Chen">Feng Chen</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Yang, Shou Bo" sort="Yang, Shou Bo" uniqKey="Yang S" first="Shou-Bo" last="Yang">Shou-Bo Yang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Li, Wen Bin" sort="Li, Wen Bin" uniqKey="Li W" first="Wen-Bin" last="Li">Wen-Bin Li</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">31923107</idno><idno type="pmc">7028209</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028209</idno><idno type="RBID">PMC:7028209</idno><idno type="doi">10.1097/CM9.0000000000000568</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000993</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000993</idno><idno type="wicri:Area/Pmc/Curation">000993</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000993</idno><idno type="wicri:Area/Pmc/Checkpoint">000283</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000283</idno><idno type="wicri:Area/Ncbi/Merge">002777</idno><idno type="wicri:Area/Ncbi/Curation">002777</idno><idno type="wicri:Area/Ncbi/Checkpoint">002777</idno><idno type="wicri:doubleKey">0366-6999:2020:Zheng X:efficacy:and:safety</idno><idno type="wicri:Area/Main/Merge">000409</idno><idno type="wicri:Area/Main/Curation">000409</idno><idno type="wicri:Area/Main/Exploration">000409</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Efficacy and safety of chimeric antigen receptor-T cells in the treatment of B cell lymphoma: a systematic review and meta-analysis</title><author><name sortKey="Zheng, Xiao Hong" sort="Zheng, Xiao Hong" uniqKey="Zheng X" first="Xiao-Hong" last="Zheng">Xiao-Hong Zheng</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Zhang, Xi You" sort="Zhang, Xi You" uniqKey="Zhang X" first="Xi-You" last="Zhang">Xi-You Zhang</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Dong, Qian Qian" sort="Dong, Qian Qian" uniqKey="Dong Q" first="Qian-Qian" last="Dong">Qian-Qian Dong</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of General Medicine, Ningbo Medical Center, Li Huili Hospital, Ningbo, Zhejiang 315000, China.</nlm:aff><country xml:lang="fr" wicri:curation="lc">République populaire de Chine</country><wicri:regionArea>Department of General Medicine, Ningbo Medical Center, Li Huili Hospital, Ningbo, Zhejiang 315000</wicri:regionArea><wicri:noRegion>Zhejiang 315000</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Feng" sort="Chen, Feng" uniqKey="Chen F" first="Feng" last="Chen">Feng Chen</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Yang, Shou Bo" sort="Yang, Shou Bo" uniqKey="Yang S" first="Shou-Bo" last="Yang">Shou-Bo Yang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Li, Wen Bin" sort="Li, Wen Bin" uniqKey="Li W" first="Wen-Bin" last="Li">Wen-Bin Li</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Neuro-Oncology, Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070</wicri:regionArea><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author></analytic><series><title level="j">Chinese Medical Journal</title><idno type="ISSN">0366-6999</idno><idno type="eISSN">2542-5641</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec sec-type="background"><title>Background</title><p>Conventional treatment has limited efficacy in relapsed/refractory B-cell lymphoma. Since chimeric antigen receptor T-cell (CAR-T) technology has shown high safety and results in high remission rates, we investigated its efficacy and safety in B-cell lymphoma treatment and analyzed potential affecting factors to provide evidence for therapeutic strategies and applications.</p></sec><sec sec-type="methods"><title>Methods</title><p>We searched databases including PubMed, Embase, and Cochrane up to July 2019. Meta-analysis 1 was conducted to study the efficacy of CAR-T cell for treating B-cell lymphoma, measuring the response rate and complete remission rate as outcomes. Sub-group analysis was performed for age, pathological type, target antigen, co-stimulatory molecule, and conditioning chemotherapy. Meta-analysis 2 was undertaken on the safety of the treatment with the incidence rate of toxicity (cytokine-releasing syndrome [CRS], neurotoxicity) as an outcome.</p></sec><sec sec-type="results"><title>Results</title><p>Seventeen studies were included in the systematic review and meta-analysis. It was found that CAR-T cells had good therapeutic effects in the following cases: B-cell lymphoma (patients ≥65 years old); diffuse large B-cell lymphoma pathological type; patients with treatment target antigen other than CD19; patients treated with co-stimulatory molecules other than CD28, including 4-1BB+CD28 or 4-1BB; and patients treated with cyclophosphamide/fludarabine pre-treatment protocol conditioning chemotherapy. Although the CRS and neurotoxicity incidences were high, most were reversible with minimal risk of death.</p></sec><sec sec-type="conclusion"><title>Conclusion</title><p>CAR-T cell treatment is safe for clinical application; however, toxicity effects should be monitored.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Siegel, Rl" uniqKey="Siegel R">RL Siegel</name></author><author><name sortKey="Miller, Kd" uniqKey="Miller K">KD Miller</name></author><author><name sortKey="Jemal, A" uniqKey="Jemal A">A Jemal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Hamadani, M" uniqKey="Al Hamadani M">M Al-Hamadani</name></author><author><name sortKey="Habermann, Tm" uniqKey="Habermann T">TM Habermann</name></author><author><name sortKey="Cerhan, Jr" uniqKey="Cerhan J">JR Cerhan</name></author><author><name sortKey="Macon, Wr" uniqKey="Macon W">WR Macon</name></author><author><name 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uniqKey="Rademaker A">AW Rademaker</name></author><author><name sortKey="Gordon, Li" uniqKey="Gordon L">LI Gordon</name></author><author><name sortKey="Lacasce, As" uniqKey="Lacasce A">AS Lacasce</name></author><author><name sortKey="Crosby Thompson, A" uniqKey="Crosby Thompson A">A Crosby-Thompson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Neelapu, Ss" uniqKey="Neelapu S">SS Neelapu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kochenderfer, Jn" uniqKey="Kochenderfer J">JN Kochenderfer</name></author><author><name sortKey="Dudley, Me" uniqKey="Dudley M">ME Dudley</name></author><author><name sortKey="Carpenter, Ro" uniqKey="Carpenter R">RO Carpenter</name></author><author><name sortKey="Kassim, Sh" uniqKey="Kassim S">SH Kassim</name></author><author><name sortKey="Rose, Jj" uniqKey="Rose J">JJ Rose</name></author><author><name sortKey="Telford, Wg" uniqKey="Telford W">WG Telford</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Turtle, Cj" uniqKey="Turtle C">CJ Turtle</name></author><author><name sortKey="Hanafi, La" uniqKey="Hanafi L">LA Hanafi</name></author><author><name sortKey="Berger, C" uniqKey="Berger C">C Berger</name></author><author><name sortKey="Gooley, Ta" uniqKey="Gooley T">TA Gooley</name></author><author><name sortKey="Cherian, S" uniqKey="Cherian S">S Cherian</name></author><author><name sortKey="Hudecek, M" uniqKey="Hudecek M">M Hudecek</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brudno, Jn" uniqKey="Brudno J">JN Brudno</name></author><author><name sortKey="Kochenderfer, Jn" uniqKey="Kochenderfer J">JN Kochenderfer</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>République populaire de Chine</li></country><settlement><li>Pékin</li></settlement></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Zheng, Xiao Hong" sort="Zheng, Xiao Hong" uniqKey="Zheng X" first="Xiao-Hong" last="Zheng">Xiao-Hong Zheng</name></noRegion><name sortKey="Chen, Feng" sort="Chen, Feng" uniqKey="Chen F" first="Feng" last="Chen">Feng Chen</name><name sortKey="Dong, Qian Qian" sort="Dong, Qian Qian" uniqKey="Dong Q" first="Qian-Qian" last="Dong">Qian-Qian Dong</name><name sortKey="Li, Wen Bin" sort="Li, Wen Bin" uniqKey="Li W" first="Wen-Bin" last="Li">Wen-Bin Li</name><name sortKey="Yang, Shou Bo" sort="Yang, Shou Bo" uniqKey="Yang S" first="Shou-Bo" last="Yang">Shou-Bo Yang</name><name sortKey="Zhang, Xi You" sort="Zhang, Xi You" uniqKey="Zhang X" first="Xi-You" last="Zhang">Xi-You Zhang</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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