Cardiovascular adverse events after CAR-T, BiTEs and TILs therapies: a systematic review and meta-analysis
Notice bibliographique
Résumé
Abstract Introduction Cancer immunotherapy with chimeric antigen receptor T-cells (CAR-T), tumor-infiltrating lymphocyte (TILs) therapy, or bispecific T-cell engagers (BiTEs) has significantly improved cancer outcomes. However, these treatments are associated with a range of adverse cardiovascular (CV) events. Purpose Our objective was to provide a comprehensive assessment of cardiovascular adverse event rates associated with these immunotherapies through a systematic review and meta-analysis of published studies in adult patients with cancer. Methods We systematically searched PubMed, MEDLINE, and EMBASE, identifying studies from January 1, 2000 to June 26, 2024. We included studies that reported CV events in patients receiving CAR-T, BiTEs, or TILs. Studies were categorized as either clinical trials or observational studies, with the latter comprising retrospective cohorts, prospective cohorts, and registry studies. For each outcome, we conducted a random-effects meta-analysis of proportions or incidence rates. In this abstract, we report on heart failure, arrhythmias, and cytokine release syndrome (CRS). Our meta-analyses of proportions focused on incidence at 30-days and 90-days. Meta-analyses of incidence rate focused on overall incidence rates per 1000 patient days followed (for studies with varying follow-up periods – patient days calculated with the total sample size and average length of follow-up reported per study). Results We identified 107 studies for inclusion: 79 CAR-T studies (8044 patients), 18 BiTEs studies (5633 patients), and 10 TILs studies (335 patients). The analysis predominantly included clinical trials (n=79), with a smaller proportion of observational studies. CRS: CAR-T therapy exhibited the highest rates of CRS at 85.7% (95% CI, 78.1%-94.0%), compared to TILs at 0.8% (95% CI, 0.0%-11.9%), and BiTEs at 7.7% (95% CI, 3.7%-16.2%) at 30 days. Observational studies reported a higher incidence of CRS within the first 30 days compared to clinical trials. No significant differences were observed in longer-term rates. Heart Failure: Heart failure had a 30-day incidence of 1.1% (95% CI, 0.6%-2.0%) and a 90-day incidence of 1.4% (95% CI, 0.7%-2.7%), with an incidence rate of 1 per 10,000 patient-days. No major differences were found between different therapy types or study designs. Arrhythmia: Arrhythmia had a 30-day incidence of 4.6% (95% CI, 2.3%-9.1%) and a 90-day incidence of 1.5% (95% CI, 0.7%-3.6%), with an incidence rate of 2 per 10,000 patient-days. No significant differences were observed between therapy types; however, in terms of design, higher rates were reported in observational studies only at 30 days. Conclusion Our meta-analysis provides an estimate of the CRS in patients receiving various immunotherapies and the incidence of clinically important CV events. Although arrhythmias were more common that heart failure, the overall incidence at 30 and 90 days of follow-up remains low.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».