Safety and efficacy of anti-BCMA CAR-T cell therapy in older adults with multiple myeloma : A systematic review and meta-analysis
Copyright © 2023 Elsevier Ltd. All rights reserved..
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
|---|---|
| Enthalten in: |
Journal of geriatric oncology - 15(2024), 2 vom: 01. Feb., Seite 101628 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Akhtar, Othman Salim [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-BCMA CAR-T therapy |
|---|
| Anmerkungen: |
Date Completed 20.02.2024 Date Revised 20.02.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jgo.2023.101628 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM362198802 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM362198802 | ||
| 003 | DE-627 | ||
| 005 | 20240220232151.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jgo.2023.101628 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1300.xml |
| 035 | |a (DE-627)NLM362198802 | ||
| 035 | |a (NLM)37723045 | ||
| 035 | |a (PII)S1879-4068(23)00225-4 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Akhtar, Othman Salim |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Safety and efficacy of anti-BCMA CAR-T cell therapy in older adults with multiple myeloma |b A systematic review and meta-analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 20.02.2024 | ||
| 500 | |a Date Revised 20.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Ltd. All rights reserved. | ||
| 520 | |a 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) | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 520 | |a CONCLUSION: Older adults experience comparable outcomes to younger patients with anti-BCMA CAR-T therapy, albeit with numerically higher rates of neurotoxicity | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Anti-BCMA CAR-T therapy | |
| 650 | 4 | |a CAR-T therapy | |
| 650 | 4 | |a Cellular therapy | |
| 650 | 4 | |a Multiple myeloma | |
| 650 | 4 | |a Older adults | |
| 650 | 7 | |a Receptors, Chimeric Antigen |2 NLM | |
| 700 | 1 | |a Sheeba, Ba Aqeel |e verfasserin |4 aut | |
| 700 | 1 | |a Azad, Farhan |e verfasserin |4 aut | |
| 700 | 1 | |a Alessi, Lauren |e verfasserin |4 aut | |
| 700 | 1 | |a Hansen, Doris |e verfasserin |4 aut | |
| 700 | 1 | |a Alsina, Melissa |e verfasserin |4 aut | |
| 700 | 1 | |a Baz, Rachid |e verfasserin |4 aut | |
| 700 | 1 | |a Shain, Kenneth |e verfasserin |4 aut | |
| 700 | 1 | |a Grajales Cruz, Ariel |e verfasserin |4 aut | |
| 700 | 1 | |a Castaneda Puglianini, Omar |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Hien |e verfasserin |4 aut | |
| 700 | 1 | |a Blue, Brandon |e verfasserin |4 aut | |
| 700 | 1 | |a Nishihori, Taiga |e verfasserin |4 aut | |
| 700 | 1 | |a Al Jumayli, Mohammed |e verfasserin |4 aut | |
| 700 | 1 | |a Extermann, Martine |e verfasserin |4 aut | |
| 700 | 1 | |a Locke, Frederick L |e verfasserin |4 aut | |
| 700 | 1 | |a Mhaskar, Rahul |e verfasserin |4 aut | |
| 700 | 1 | |a Freeman, Ciara Louise |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of geriatric oncology |d 2010 |g 15(2024), 2 vom: 01. Feb., Seite 101628 |w (DE-627)NLM203939069 |x 1879-4076 |7 nnns |
| 773 | 1 | 8 | |g volume:15 |g year:2024 |g number:2 |g day:01 |g month:02 |g pages:101628 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jgo.2023.101628 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 15 |j 2024 |e 2 |b 01 |c 02 |h 101628 | ||