A recent meta-analysis reviewed data across 146 patients in 9 clinical trials.
A review of allogeneic chimeric antigen receptor (CAR) T-cell therapy in B-cell malignancies has revealed acceptable efficacy and safety in this population.
Findings from the meta-analysis were presented at the 2022 American Society of Clinical Oncology (ASCO) meeting, held June 3-7, 2022, held both virtually and in Chicago, Illinois by Asmi Chattaraj, MD, internal medicine resident, University of Pittsburgh Medical Center.
“Immunotherapy with CAR T-cells has proven effective in recent trials for patients with B cell malignancies, who relapsed after stem cell transplantation. Genetically modified allogeneic CAR T-cells used in advanced B cell malignancy engage with multiple target allo-antigens along with CD19 and/or CD20, leading to elimination of malignant B cells resulting in a potent graft versus malignancy effect with avoidance of tumor escape,” Chattaraj and colleagues wrote. “Some concerns regarding their use exist like life-threatening graft-versus-host disease (GVHD) and rapid clearance by the host immune system."
Chattarj and colleagues conducted a systematic literature search throughout PubMed, Embase, Cochrane and Clinicaltrials.gov from inception to Jan 26, 2022, filtering with MeSH terms and keywords for B cell malignancies and CD19 targeted CAR-T therapy.
The investigators screened data from conferences and previous systematic reviews and altogether retrieved 1247 articles and data from 146 patients in 9 clinical trials. The most common malignancy, affecting 125 patients (86%) was acute lymphoblastic leukemia. Patients’ median ages ranged from 19 to 49 years and cell doses ranged from 0.4×106 to 5×108 cells/kg.
They then pooled outcomes including complete remission (CR), 1-year overall survival (OS), GVHD, cytokine release syndrome (CRS), and immune effector cell associated neurotoxicity (ICANS) with the Freeman-Tukey double arcsine transformation a random effects model in OpenMetaAnalyst software.
Chattaraj and colleagues found that 93 patients had a CR, with a pooled rate of 63% (95% CI, 47.4-78.6; I2, 78.5). The pooled rate of OS was 57.3% (95% CI, 30.8-82; I2, 79.2). In looking at adverse events, they found that pooled rate of GVHD was 9.4% (95% CI, 3.1-15.6; I2, 47.6), pooled CRS rate was 59.3% (95% CI, 30.5-88.1; I2, 95.2%) and pooled ICANS rate was 15.4% (95% CI, 4.6-26.3; I2, 72.7).
“Allogeneic CAR-T therapy has demonstrated acceptable efficacy and safety in B cell malignancies, with CR being reported in about 60% of patients and GVHD in < 10% of patients. Although allogeneic CAR-T cells are showing promise, several trials are ongoing and we need longer follow up,” Chattaraj and colleagues concluded.
To read more coverage of ASCO 2022, click here.