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CAR-T cell therapy for patients with hematological malignancies. A systematic review.
Pasqui, Daniel M; Latorraca, Carolina D O C; Pacheco, Rafael L; Riera, Rachel.
Affiliation
  • Pasqui DM; Discipline of Evidence-Based Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, São Paulo, Brazil.
  • Latorraca CDOC; Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil.
  • Pacheco RL; Department of Medicine, Centro Universitário São Camilo (CUSC), São Paulo, São Paulo, Brazil.
  • Riera R; Núcleo de Ensino e Pesquisa em Saúde Baseada em Evidências e Avaliação de Tecnologias em Saúde (NEP-SBEATS), Universidade Federal de São Paulo (Unifesp), São Paulo, São Paulo, Brazil.
Eur J Haematol ; 109(6): 601-618, 2022 Dec.
Article in En | MEDLINE | ID: mdl-36018500
Hematological malignancies represent defying clinical conditions, with high levels of morbidity and mortality, particularly considering patients who manifest multiple refractory diseases. Recently, chimeric antigen receptor (CAR)-T cell therapy has emerged as a potential treatment option for relapsed/refractory B cell malignancies, which have motivated the Food and Drug Administration approval of a series of products based on this technique. The objective of this systematic review was to assess the efficacy and safety of CAR-T cell therapy for patients with hematological malignancies. A comprehensive literature search was conducted in the electronic databases (CENTRAL, Embase, LILACS, and MEDLINE), clinical trials register platforms (Clinicaltrials.gov and WHO-ICTRP), and grey literature (OpenGrey). The Cochrane Handbook for Reviews of Interventions was used for developing the review and the PRISMA Statement for manuscript reporting. The protocol was prospectively published in PROSPERO database (CRD42020181047). After the selection process, seven RCTs were included, three of which with available outcome results. The available results are from studies assessing axicabtagene, lisocabtagene, and tisagenlecleucel for patients with B cell lymphoma, and the certainty of evidence ranged from very low to low for survival and progression-related outcome and for safety outcomes. Additionally, four randomized controlled trials comparing CAR-T cell therapy to the standard treatment for various types of relapsed/refractory B cell non-Hodgkin lymphomas and multiple myeloma included in this systematic review still did not have available outcome data. The results of this review may be used to guide clinical practice but evidence concerning the safety and efficacy of CAR-T Cell therapy for hematological malignancies is still immature to recommend its application outside of clinical trials or compassionate use context for advanced and terminal cases. It is expected the results of the referred comparative studies will provide further elements to subsidize the broader application of this immunotherapy.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Lymphoma, B-Cell / Hematologic Neoplasms / Receptors, Chimeric Antigen Type of study: Clinical_trials / Diagnostic_studies / Etiology_studies / Guideline / Systematic_reviews Limits: Humans Language: En Journal: Eur J Haematol Journal subject: HEMATOLOGIA Year: 2022 Document type: Article Affiliation country: Brazil Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Lymphoma, B-Cell / Hematologic Neoplasms / Receptors, Chimeric Antigen Type of study: Clinical_trials / Diagnostic_studies / Etiology_studies / Guideline / Systematic_reviews Limits: Humans Language: En Journal: Eur J Haematol Journal subject: HEMATOLOGIA Year: 2022 Document type: Article Affiliation country: Brazil Country of publication: United kingdom