A Meta-analysis Of The Efficacy Of CAR-T In The Treatment Of Relapsed/refractory DLBCL

Objective:To systematically evaluate the efficacy of car-t in the treatment of relapsed/refractory DLBCL and evaluate its complete response rate,providing a more adequate theoretical basis for clinical treatment.Methods:PubMed,Cochrane Library,CNKI,VIP,CBM and Wanfang databases were searched by computer until January 2019.Two investigators independently selected the literature on the basis of the inclusion standards and exclusion standards,extracted the data,sorted and summarized the data,and conducted meta-analysis with RevMan 5.3 software.Results:Finally,the consistent studies was 13,with 263 cases.There was no heterogeneity in the all researchs,and the fixed effect model was adopted.According to the results of Meta analysis,the total complete response rate of R/R DLBCL in car-t treatment was 46.8%(95%CI:0.408～0.533).The results of subgroup analysis showed that the complete response rate was 52.5%(95%ci:0.441～0.602)in the group containing CD28 costimulator,and 41.5%(95%ci:0.324～0.510)in the group containing 4-1bb costimulator.The complete response rate of CD 19 target antigen group was 49.2%(95%CI:0.429～0.556).The complete response rate of the CD20 target antigen group was 42.2%(95%CI:0.231～0.639).Conclusion:Car-t treatment of R/R DLBCL is more effective and has a higher complete response rate than traditional treatment.Car-t cells containing CD28 co-stimulators had a higher complete response rate than those containing 4-1bb co-stimulators,and there was no significant difference in the complete response rate between CD 19 target antigen and CD20 target antigen,while the complete response rate of CD 19 target antigen was slightly higher.According to the present results,car-t cell immunotherapy is expected to become the mainstream therapy for hemolytic lymphatic system tumors.