KEY TAKEAWAYS
- The study aimed to evaluate the efficacy and safety of CAR T-cell therapy for individuals with r/r B-ALL.
- The study concluded that CAR T-cell improvements are crucial for enhancing survival in acute leukemia, suggesting the exploration of new targets.
Pediatric cancer presents a challenging prognosis, particularly in cases of relapsed/refractory B-cell acute lymphoblastic leukemia (r/r B-ALL). Although CAR T-cell therapy is an advanced treatment option, its efficacy remains controversial due to high relapse rates and adverse events.
Sebastian Emmanuel Willyanto and the team aimed to evaluate the effectiveness and safety of CAR T-cell therapy for individuals with r/r B-ALL.
The study conducted a literature search on 4 databases. Efficacy parameters focused on minimal residual disease negative complete remission (MRD-CR) and relapse rate (RR). Safety parameters included cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).
The results revealed that anti-CD22 exhibited superior efficacy, displaying the highest rate of MRD-CR events and the lowest RR compared to anti-CD19. Combining CAR T-cell therapy with haploidentical stem cell transplantation improved RR.
Safety-wise, bispecific anti-CD19/22 showed the lowest CRS rate, while anti-CD22 demonstrated the fewest cases of ICANS. Analysis of costimulatory receptors indicated that adding CD28ζ to anti-CD19 CAR T-cell therapy demonstrated superior efficacy in reducing relapses, with favorable safety profiles.
The study concluded that selecting a more effective and safer CAR T-cell treatment is vital for enhancing overall survival in acute leukemia. Beyond the promising anti-CD22 CAR T-cell therapy, further exploration of costimulatory domains and new CD targets could potentially improve treatment effectiveness for individuals with r/r B-ALL.
Funding was provided by the World Class University Universitas Brawijaya.
Source: https://pubmed.ncbi.nlm.nih.gov/38738799/
Willyanto SE, Alimsjah YA, Tanjaya K, et al. (2024). “Comprehensive analysis of the efficacy and safety of CAR T-cell therapy in patients with relapsed or refractory B-cell acute lymphoblastic leukaemia: a systematic review and meta-analysis.” Ann Med. 2024 Dec;56(1):2349796. doi: 10.1080/07853890.2024.2349796. Epub 2024 May 13. PMID: 38738799.
