By Cecilia Brown - September 29, 2023
Dual targeting of CD22 and CD19 with chimeric antigen receptor (CAR) T-cell therapy showed “high efficiency” in patients with acute lymphoblastic leukemia (ALL) and other B-cell malignancies, according to a recent study.
Thi Thuy Nguyen, MD, PhD, of Taipei Medical University in Taiwan and the Hue University of Medicine and Pharmacy in Vietnam, and colleagues conducted the meta-analysis and published their findings in Cancer Medicine.
They conducted the research on targeting both CD22 and CD19 with CAR T-cell therapy in relapsed or refractory B-cell malignancies because “antigen loss and lack of CAR T-cell persistence are the leading causes of progressive disease following single-antigen targeting.”
Researchers Evaluate Efficacy, Safety of Dual-Targeting CAR-T
Dr. Nguyen and colleagues searched the Web of Science, PubMed, Cochrane, and Embase databases until July 2022. They included 14 studies in the analysis. Those studies included a total of 405 patients with a confirmed diagnosis of a relapsed or refractory B-cell hematological malignancy who received CAR T-cell therapy that dually targeted CD22 and CD19. All patients were included regardless of age, gender, or ethnicity. The researchers excluded studies evaluating the therapy in patients with coexisting cancers.
The pooled overall response rate (ORR) was 97% and the pooled complete remission (CR) rate was 93% in patients with ALL. The one-year overall survival (OS) rate was 70% and the one-year progression-free survival (PFS) rate was 49%.
In patients with non-Hodgkin lymphoma, the ORR was 85%, with a CR rate of 57%. The one-year OS rate was 77% and the one-year PFS rate was 65% in patients with non-Hodgkin lymphoma.
The subgroup analysis showed that the dual-targeting CAR-T achieved a higher CR rate when patients received coadministration of CD22 and CD19 CAR-T cells or received third-generation CAR-T cells combined with autologous hematopoietic stem cell transplant and carmustine, etoposide, cytarabine, and melphalan pretreatment.
Treatment-related toxicity “seemed similar” between the patients with ALL and those with non-Hodgkin lymphoma, Dr. Nguyen and colleagues reported. All-grade cytokine release syndrome (CRS) occurred in 86% of patients, severe CRS occurred in 7%, and neurotoxicity occurred in 12%.
Our meta-analysis demonstrated that the CD22/CD19 dual-targeting CAR T-cell strategy has high efficiency with tolerable adverse effects in B-cell malignancies,” Dr. Nguyen and colleagues concluded.
Nguyen TT, Thanh Nhu N, Chen CL, Lin CF. Effectiveness and safety of CD22 and CD19 dual‐targeting chimeric antigen receptor T‐cell therapy in patients with relapsed or refractory B‐cell malignancies: A meta‐analysis. Cancer Med. 2023. doi:10.1002/cam4.6497
Original Source: Dual Targeting of CD22, CD19 with CAR-T Shows Efficacy in Relapsed, Refractory ALL | Blood Cancers Today