A systematic review on performance analysis of critical time points in multiple myeloma treated by CAR-T cell immunotherapy

Yue Zhang; Wenjiao Tang; Yan Li; Yuyao Yi; Zhengyu Yu; Xiang Liu; Li Zhang; Yuhuan Zheng; Ting Niu

doi:10.1016/j.intimp.2022.109592

A systematic review on performance analysis of critical time points in multiple myeloma treated by CAR-T cell immunotherapy

Int Immunopharmacol. 2023 Jan:114:109592. doi: 10.1016/j.intimp.2022.109592. Epub 2022 Dec 20.

Authors

Yue Zhang¹, Wenjiao Tang¹, Yan Li¹, Yuyao Yi², Zhengyu Yu¹, Xiang Liu¹, Li Zhang³, Yuhuan Zheng⁴, Ting Niu¹

Affiliations

¹ Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, #37 Guo Xue Xiang Street, 610041 Chengdu, China.
² Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, #37 Guo Xue Xiang Street, 610041 Chengdu, China; Clinical Trial Center, National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Innovative Drugs, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
³ Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, #37 Guo Xue Xiang Street, 610041 Chengdu, China. Electronic address: zhangli@wchscu.cn.
⁴ Department of Hematology, Institute of Hematology, West China Hospital, Sichuan University, #37 Guo Xue Xiang Street, 610041 Chengdu, China. Electronic address: zhengyuhuan@scu.edu.cn.

PMID: 36700772
DOI: 10.1016/j.intimp.2022.109592

Abstract

Background: Multiple myeloma (MM) is the second most common hematological malignancy without cure, and Chimeric Antigen Receptor T Cell (CAR-T) therapy has been shown great promising in MM. Unlike previous published studies mainly focusing on efficacy and safety, this study aims to summarize time points in the process of CAR-T therapy in MM and establish a standardized time-related CAR-T therapy platform to provide a reference for CAR-T treatment in MM.

Methods: All the literatures were retrieved from PubMed, Web of Science, Embase, American Society of Hematology (ASH), American Society of Clinical Oncology (ASCO) and European Hematology Association (EHA). Relevant median detection time of efficacy and safety-related indicators of CAR-T therapy in MM were extracted from included literatures, and median values were applied to represent detection time points of indicators. Notably, the median values were not the certain and optimal detection time points, while the significance is that indicators could be detected more frequently around the median values to obtain the ideal results.

Results: This review presented the median detection time points of efficacy and safety-related indicators of CAR-T therapy in MM according to the chronological order. For short-term effects on inflammation status within 1 month after CAR-T initiation, the median time points of cytokine release syndrome onset, immune effector cell-associated neurotoxicity syndrome onset, neutrophils recovery and CAR-T expansion peak were 4.5, 8, 10 and 12 days, respectively. For medium-term effects on clinical response in MM beyond 1 month and up to 3 months following CAR-T infusion, the median time points of minimal residual disease negativity, the reduction of serum light chain to minimum, platelet recovery and the reduction of M protein to minimum were 30, 30, 44 and 90 days, respectively.

Conclusions: This systematic review summarized the median detection time points of efficacy and safety-related indicators of CAR-T therapy in MM and constructed the time-related CAR-T therapy platform, providing an evidence-based standard for establishment of CAR-T treatment regimen in MM.

Keywords: CAR-T; Multiple myeloma; Systematic review; Time points.

Publication types

Systematic Review

MeSH terms

Humans
Immunotherapy
Immunotherapy, Adoptive / adverse effects
Immunotherapy, Adoptive / methods
Multiple Myeloma* / drug therapy
Receptors, Chimeric Antigen*
T-Lymphocytes

Substances

Receptors, Chimeric Antigen
cell-associated neurotoxicity