PMID- 35568624
OWN - NLM
STAT- MEDLINE
DCOM- 20220823
LR  - 20220826
IS  - 1477-2566 (Electronic)
IS  - 1465-3249 (Linking)
VI  - 24
IP  - 9
DP  - 2022 Sep
TI  - Systematic review and meta-analysis of the association between bridging therapy 
      and outcomes of chimeric antigen receptor T cell therapy in patients with large B 
      cell lymphoma.
PG  - 940-953
LID - S1465-3249(22)00099-8 [pii]
LID - 10.1016/j.jcyt.2022.03.009 [doi]
AB  - BACKGROUND: The existing evidence about the impact of bridging therapy (BT) on 
      chimeric antigen receptor (CAR)-T cell therapy in patients with large B cell 
      lymphoma (LBCL) is conflicting. Therefore, we reviewed all available evidence to 
      examine the association between BT and CAR-T therapy outcomes by systematic 
      review and meta-analysis approach. METHODS: Two reviewers independently searched 
      Embase, PubMed, Web of Science, and Cochrane library to identify all records that 
      described BT for LBCL treated with CAR-T. We then applied a fixed- or 
      random-effects meta-analysis to estimate the pooled hazard ratios (HRs) and rate 
      ratio (RRs) for efficacy and safety endpoints and assessed differences across 
      various BT modalities. The Newcastle-Ottawa Scale was used to evaluate study 
      quality. RESULTS: Twenty-six reports from 24 studies involving 2014 patients were 
      included in the analysis. Pooled results showed that patients requiring BT had 
      significantly worse 1-year overall survival rate (RR = 0.76, 95% confidence 
      interval [CI] 0.68-0.85, P < 0.001), 1-year progression-free survival rate 
      (RR = 0.71, 95% CI 0.60-0.85, P < 0.001), progression-free survival (HR = 1.35, 
      95% CI 1.07-1.69, P = 0.01), overall response rate (RR = 0.88, 95% CI 0.81-0.95, 
      P = 0.001), complete response rate (RR = 0.78, 95% CI 0.65-0.93, P = 0.005), and 
      grade >/=3 immune effector cell-associated neurotoxicity syndrome (RR = 1.43, 95% 
      CI 1.10-1.87, P = 0.007), and tended to have poorer overall survival (HR = 1.42, 
      95% CI 0.99-2.02, P = 0.056) and grade >/=3 cytokine release syndrome (RR = 1.59, 
      95% CI 0.92-2.75, P = 0.096). Prolonged cytopenias were the common toxicity event 
      associated with BT. Radiotherapy may serve as a promising BT option that can 
      provide safe and effective disease control for patients with LBCL before CAR-T 
      infusion. The inconsistency of patient baselines in the current study hindered 
      further comparisons between different BT modalities. Most of the available 
      evidence was rated as low quality because of concerns over low comparability. 
      CONCLUSION: BT appears to be associated with comparatively poor efficacy and 
      safety outcomes after CAR-T infusion. However, due to the considerable 
      heterogeneity between the BT and non-BT cohorts at disease baseline, no 
      definitive conclusions can be made for the true impact of BT on CAR-T until 
      further randomized studies are conducted.
CI  - Copyright (c) 2022 International Society for Cell & Gene Therapy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Sun, Zhen
AU  - Sun Z
AD  - Hengyang Medical School, University of South China, Hengyang, China. Electronic 
      address: slzms@foxmail.com.
FAU - Liu, MengSi
AU  - Liu M
AD  - Hengyang Medical School, University of South China, Hengyang, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220511
PL  - England
TA  - Cytotherapy
JT  - Cytotherapy
JID - 100895309
RN  - 0 (Receptors, Chimeric Antigen)
SB  - IM
MH  - Cell- and Tissue-Based Therapy
MH  - Cytokine Release Syndrome
MH  - Humans
MH  - *Immunotherapy, Adoptive
MH  - *Lymphoma, B-Cell/therapy
MH  - Progression-Free Survival
MH  - Receptors, Chimeric Antigen
MH  - Treatment Outcome
OTO - NOTNLM
OT  - bridging therapy
OT  - chimeric antigen receptor T cells
OT  - efficacy
OT  - radiation therapy
OT  - safety
OT  - systematic therapy
COIS- Declaration of Competing Interest The authors have no commercial, proprietary or 
      financial interest in the products or companies described in this article.
EDAT- 2022/05/15 06:00
MHDA- 2022/08/24 06:00
CRDT- 2022/05/14 22:06
PHST- 2021/12/11 00:00 [received]
PHST- 2022/03/06 00:00 [revised]
PHST- 2022/03/14 00:00 [accepted]
PHST- 2022/05/15 06:00 [pubmed]
PHST- 2022/08/24 06:00 [medline]
PHST- 2022/05/14 22:06 [entrez]
AID - S1465-3249(22)00099-8 [pii]
AID - 10.1016/j.jcyt.2022.03.009 [doi]
PST - ppublish
SO  - Cytotherapy. 2022 Sep;24(9):940-953. doi: 10.1016/j.jcyt.2022.03.009. Epub 2022 
      May 11.