靶向CD30的嵌合抗原受体T细胞治疗淋巴瘤有效性及安全性的Meta分析  

Efficacy and safety of targeted CD30 chimeric antigen receptor T cellin treatment of lymphoma:a Meta analysis

作　　者：李庆[1] 陈姝[1] LI Qing;CHEN Shu(Department of Hematology,Second Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China)

机构地区：[1]重庆医科大学附属第二医院血液内科,重庆400000

出　　处：《检验医学与临床》2023年第7期915-919,924,共6页Laboratory Medicine and Clinic

摘　　要：目的 探讨靶向CD30的嵌合抗原受体T细胞(CAR-T)治疗淋巴瘤的有效性及安全性。方法 通过计算机检索中国生物医学文献数据库、中国知网、维普网、万方数据库、PubMed、Embase、Web of Science以及Cochrane Library和临床试验中心,以确定正在进行的和已完成的试验,收集有关靶向CD30的CAR-T治疗淋巴瘤的有效性和安全性研究的临床试验。将检索结果进行筛选和评价之后,采用Meta分析对数据进行整合,对数据不能进行合并者进行描述。结果 共纳入5项单臂研究的临床试验。Meta分析结果显示:客观缓解率为54%(95%CI 43%~65%);完全缓解率为51%(95%CI 38%~63%);部分缓解率为5%(95%CI 1%~13%);疾病稳定率为17%(95%CI 9%~26%);疾病进展率为25%(95%CI 15%~35%);5篇文献中治疗的不良反应表现差异较大,但多数为可控制的轻度不良反应,严重不良反应少见,主要表现为轻度细胞因子释放综合征,神经系统的严重不良反应少见。结论 目前关于靶向CD30的CAR-T疗法对淋巴瘤治疗的研究较少见,已知的试验结论展现出该疗法有较高的缓解率,常见不良反应为轻度细胞因子释放综合征,而与该治疗直接相关的严重不良反应少见。该疗法在淋巴瘤中有良好应用前景,进一步的探索很有必要。Objective To investigate the efficacy and safety of targeted CD30 chimeric antigen receptor T cells(CAR-T)in the treatment of lymphoma.Methods The databases of SinoMed,CNKI,CQVIP,WanFang Data,PubMed,EmBase,Web of Science,Cochrane Library and Clinical Trials Center were retrieved by computer to confirm the ongoing and completed trials,and the clinical trials on the efficacy and safety of CD30 CAR-T in the treatment of lymphoma were collected.After screening and evaluating the retrieval results,the Meta analysis was used to integrate the data,and the data that could not be combined were described.Results A total of 5 clinical trials of single arm studies were included.The Meta analysis results showed that the objective remission rate was 54%(95%CI 43%-65%),the complete remission rate was 51%(95%CI 38%-63%),the partial remission rate was 5%(95%CI 1%-13%),the disease stability rate was 17%(95%CI 9%-26%),and the disease progression rate was 25%(95%CI 15%-35%).In the five trials of this study,the adverse reactions of treatment were different,but most of them were controllable mild adverse reactions,and severe adverse reactions were rare,the main manifestation was mild cytokine release syndrome,and severe adverse reactions of nervous system were rare.Conclusion Currently,there are few studies on the CD30 CAR-T therapy for lymphoma.The known trials conclusion have shown a high remission rate of this therapy,the common adverse reaction is mild cytokine release syndrome,and serious adverse reactions directly related to the therapy are rare.This therapy has a promising application in lymphoma and further exploration is necessary.

关 键 词：CD30 嵌合抗原受体T细胞 淋巴瘤 安全性 

分 类 号：R551.2[医药卫生—血液循环系统疾病]