目的:尽管与B细胞恶性肿瘤相比,T细胞恶性肿瘤相对不那么普遍,它们是高度恶性的,患者通常预后较差。采用CD7靶向的嵌合抗原受体(CAR)T细胞疗法作为一种新型的免疫疗法来治疗恶性T细胞面临着许多挑战,并且处于早期阶段。为了评估这种可能性,我们旨在对相关临床试验进行系统回顾和荟萃分析.
方法:2023年10月9日,PubMed的在线数据库,Scopus,Embase,和WebofScience进行了相关研究的系统搜索。在完成两步标题/摘要和全文筛选过程后,纳入了符合条件的研究.
结果:我们观察到汇集的总反应率(ORR)为100%。部分响应(PR),严格和/或完全反应(sCR/CR),复发率为6%,85%,18%,分别。此外,微小残留病(MRD)阴性的合并率为85%.最常见的≥3级不良事件与血液学毒性有关,包括中性粒细胞减少症(100%),血小板减少症(79%),贫血(57%)。细胞因子释放综合征(CRS)也是一种常见的并发症,发生率为100%;然而,81%的CRS事件为低等级。未报告≥3级GVHD,免疫效应细胞相关神经毒性综合征(ICANS≥3级)罕见(4%).
结论:CD7是一种活跃且安全的靶标,在治疗复发和/或难治性(r/r)T细胞恶性肿瘤方面显示出有希望的结果。
OBJECTIVE: Although T-cell malignancies are relatively less prevalent compared to B-cell malignancies, they are highly malignant, and patients usually have poor prognoses. Employing CD7-targeted chimeric antigen receptor (CAR) T cell therapy as a novel immunotherapy to treat malignant T cells faces numerous challenges and is in its early phase. To evaluate this possibility, we aimed to review and meta-analyze the related clinical trials systematically.
METHODS: On October 9, 2023, the online databases of PubMed, Scopus, Embase, and Web of Science were systematically searched for pertinent studies. After completing a two-step title/abstract and full-text screening process, the eligible studies were included.
RESULTS: We observed a pooled overall response rate (ORR) of 100%. Partial response (PR), stringent and/or complete response (sCR/CR), and relapse rate were 6%, 85%, and 18%, respectively. Additionally, the pooled rate of minimal residual disease (MRD) negativity was 85%. The most common grade ≥3 adverse events were related to hematological toxicities, including neutropenia (100%), thrombocytopenia (79%), and anemia (57%). Cytokine release syndrome (CRS) was also a frequent complication with a 100% rate; however, 81% of CRS events were low grades. No grade ≥3 GVHD was reported, and the immune effector cell-associated neurotoxicity syndrome (ICANS grade ≥3) was rare (4%).
CONCLUSIONS: CD7 is an active and safe target that shows promising results in the treatment of relapsed and/or refractory (r/r) T-cell malignancies.