PMID- 35765220
OWN - NLM
STAT- MEDLINE
DCOM- 20220823
LR  - 20230918
IS  - 1365-2141 (Electronic)
IS  - 0007-1048 (Print)
IS  - 0007-1048 (Linking)
VI  - 198
IP  - 5
DP  - 2022 Sep
TI  - Chimeric antigen receptor T-cell therapy is superior to standard of care as 
      second-line therapy for large B-cell lymphoma: A systematic review and 
      meta-analysis.
PG  - 838-846
LID - 10.1111/bjh.18335 [doi]
AB  - Treatment with high-dose chemotherapy followed by autologous stem cell 
      transplantation (ASCT) is considered standard of care (SOC) second-line treatment 
      for relapsed or refractory large B-cell lymphoma (LBCL). However, outcomes remain 
      suboptimal. A systematic review and meta-analysis of randomised controlled trials 
      comparing efficacy and safety of SOC versus chimeric antigen receptor T-cell 
      (CAR-T) therapy as second-line for patients with LBCL refractory or relapsing 
      within 12 months. Outcomes included overall survival (OS), event-free survival 
      (EFS), overall response rate (ORR) and safety. Three trials published in 2021 
      (involving 865 participants) fulfilled the eligibility criteria. EFS as well as 
      OS were significantly improved with CAR-T therapy as compared to SOC, hazard 
      ratio (HR) 0.57 (95% confidence interval [CI] 0.49-0.68) and HR 0.77 (95% CI 
      0.60-0.98) respectively. CAR-T therapy was associated with significantly better 
      ORR, relative risk (RR) 1.55 (95% CI 1.12-2.13, p = 0.001). The risk of Grade 
      III/IV adverse event was comparable between the two arms, RR 1.03 (95% CI 
      0.93-1.14). In summary, CAR-T therapy has superior outcomes as compared to SOC in 
      patients with LBCL refractory or relapsing within 12 months, without excess of 
      toxicity. Longer follow-up is needed to confirm these results and determine the 
      optimal sequencing of CAR-T therapy in the management of LBCL.
CI  - (c) 2022 The Authors. British Journal of Haematology published by British Society 
      for Haematology and John Wiley & Sons Ltd.
FAU - Shargian, Liat
AU  - Shargian L
AUID- ORCID: 0000-0002-6429-148X
AD  - Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson 
      Hospital, Petach Tikva, Israel.
AD  - Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Raanani, Pia
AU  - Raanani P
AD  - Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson 
      Hospital, Petach Tikva, Israel.
AD  - Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Yeshurun, Moshe
AU  - Yeshurun M
AD  - Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson 
      Hospital, Petach Tikva, Israel.
AD  - Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Gafter-Gvili, Anat
AU  - Gafter-Gvili A
AD  - Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson 
      Hospital, Petach Tikva, Israel.
AD  - Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
AD  - Medicine A, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel.
FAU - Gurion, Ronit
AU  - Gurion R
AD  - Institute of Haematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson 
      Hospital, Petach Tikva, Israel.
AD  - Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20220628
PL  - England
TA  - Br J Haematol
JT  - British journal of haematology
JID - 0372544
RN  - 0 (Antigens, CD19)
RN  - 0 (Receptors, Antigen, T-Cell)
RN  - 0 (Receptors, Chimeric Antigen)
SB  - IM
CIN - Br J Haematol. 2023 Jan;200(1):e4-e5. PMID: 36281746
CIN - Br J Haematol. 2023 Jan;200(1):e6-e7. PMID: 36281751
MH  - Antigens, CD19
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - *Immunotherapy, Adoptive/methods
MH  - *Lymphoma, Large B-Cell, Diffuse/etiology/therapy
MH  - Neoplasm Recurrence, Local/therapy
MH  - Receptors, Antigen, T-Cell
MH  - *Receptors, Chimeric Antigen
MH  - Standard of Care
MH  - Transplantation, Autologous
PMC - PMC9542944
OTO - NOTNLM
OT  - B-cell
OT  - CAR-T
OT  - CD19 chimeric antigen receptor
OT  - diffuse large cell
OT  - lymphoma
OT  - meta-analysis
OT  - relapse: refractory
COIS- Liat Shargian-Advisory board and honoraria payment from Gilead and Novartis. Anat 
      Gafter-Gvili-Honoraria payment from Novartis. Ronit Gurion-Advisory board and 
      honoraria payment from Gilead and Novartis.
EDAT- 2022/06/30 06:00
MHDA- 2022/08/24 06:00
PMCR- 2022/10/07
CRDT- 2022/06/29 01:23
PHST- 2022/05/21 00:00 [revised]
PHST- 2022/03/26 00:00 [received]
PHST- 2022/06/14 00:00 [accepted]
PHST- 2022/06/30 06:00 [pubmed]
PHST- 2022/08/24 06:00 [medline]
PHST- 2022/06/29 01:23 [entrez]
PHST- 2022/10/07 00:00 [pmc-release]
AID - BJH18335 [pii]
AID - 10.1111/bjh.18335 [doi]
PST - ppublish
SO  - Br J Haematol. 2022 Sep;198(5):838-846. doi: 10.1111/bjh.18335. Epub 2022 Jun 28.