Safety and efficacy of anti-BCMA CAR-T cell therapy in older adults with multiple myeloma: A systematic review and meta-analysis.

Autor: Akhtar OS; Medical College of Wisconsin, Milwaukee, WI, United States of America. Electronic address: oakhtar@mcw.edu., Sheeba BA; Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America., Azad F; University at Buffalo Jacobs School of Medicine, Buffalo, NY, United States of America., Alessi L; Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America., Hansen D; Moffitt Cancer Center, Tampa, FL, United States of America., Alsina M; Moffitt Cancer Center, Tampa, FL, United States of America., Baz R; Moffitt Cancer Center, Tampa, FL, United States of America., Shain K; Moffitt Cancer Center, Tampa, FL, United States of America., Grajales Cruz A; Moffitt Cancer Center, Tampa, FL, United States of America., Castaneda Puglianini O; Moffitt Cancer Center, Tampa, FL, United States of America., Liu H; Moffitt Cancer Center, Tampa, FL, United States of America., Blue B; Moffitt Cancer Center, Tampa, FL, United States of America., Nishihori T; Moffitt Cancer Center, Tampa, FL, United States of America., Al Jumayli M; Moffitt Cancer Center, Tampa, FL, United States of America., Extermann M; Moffitt Cancer Center, Tampa, FL, United States of America., Locke FL; Moffitt Cancer Center, Tampa, FL, United States of America., Mhaskar R; University of South Florida, Tampa, FL, United States of America., Freeman CL; Moffitt Cancer Center, Tampa, FL, United States of America.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2024 Mar; Vol. 15 (2), pp. 101628. Date of Electronic Publication: 2023 Sep 16.
DOI: 10.1016/j.jgo.2023.101628
Abstrakt: Introduction: Anti-B-cell maturation antigen (BCMA) chimeric antigen receptor T-cell (CAR-T) therapy is transforming the care of patients with relapsed/refractory multiple myeloma (MM). Unfortunately, despite being a disease of older adults these patients remain under-represented in most pivotal clinical trials. We performed a systematic review and proportion meta-analysis of prospective clinical trials and observational studies of anti-BCMA CAR-T therapy in patients with MM with the aim to determine the efficacy and safety of this therapy in older adults (≥65 years).
Materials and Methods: We searched the Pubmed, Scopus, Web of Science (WOS), Ovid, Embase, CENTRAL, and CINAHL databases through September 9, 2022 and abstracts from the American Society of Hematology (ASH) Annual Meeting 2022. Primary outcome measures included overall response rate (ORR), rates of cytokine release syndrome (CRS), and immune cell-effector-associated neurotoxicity syndrome (ICANS). study was registered with PROSPERO (study number: CRD42022334287).
Results: After screening 2218 references, 14 studies were included for data extraction, with a total of 558 patients, 26.2% (n = 146) of whom were older adults. The pooled ORR amongst this population was 93%, which was comparable to the ORR of 86% amongst younger patients. In older adults, the rates of CRS (any grade) and grade ≥ 3 were 95% and 21%, respectively. For younger patients, the pooled rate of CRS (any grade) and grade ≥ 3 CRS was 91% and 20%, respectively. The rate of ICANS (any grade) in older adults was 15%, which was higher than that observed in those <65 years.
Conclusion: Older adults experience comparable outcomes to younger patients with anti-BCMA CAR-T therapy, albeit with numerically higher rates of neurotoxicity.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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