CAR T-cell therapy offers survival benefits in acute lymphoblastic leukaemia

Chimeric antigen receptor (CAR) T-cell therapy in patients with relapsed/refractory B-cell acute lymphoblastic leukaemia (r/r B-ALL) demonstrates efficacy with high rates of durable remissions, as shown in a recent meta-analysis.

Databases were searched for relevant studies up to June 2024. A total of 2,659 clinical trials on CAR T-cell therapy for patients with r/r B-ALL were identified, of which 10 met the eligibility criteria. The investigators then conducted meta-analyses using the Comprehensive Meta-Analysis V3 and Review Manager 5.4.

The pooled analysis revealed a high minimal residual disease-negative complete remission (overall event rate, 70 percent, 95 percent confidence interval [CI], 61‒78; I², 88.35 percent).

The highest efficacy was observed with anti-CD19 CAR T-cell therapy (event rate, 74.75 percent, 95 percent CI, 61‒80; I², 82.56 percent). Combination therapies targeting CD19 and CD22 also demonstrated efficacy (event rate, 69 percent, 95 percent CI, 53‒83; I², 82.56 percent).

In addition, the investigators observed significant adverse effects, including cytokine release syndrome (mean incidence, 81.8 percent, 95 percent CI, 76.7‒86.9), neurotoxicity (mean incidence, 33.2 percent, 95 percent CI< 28.1‒38.3), and haematologic toxicities (mean incidence, 71.9 percent, 95 percent CI, 66.4‒77.4).

“CAR T-cell therapy is a groundbreaking advancement in treating r/r B-ALL, offering high rates of durable remissions,” the investigators said.