Use of car-t cells immunotherapy in acute lymphblastic leukemia: an integrative review
DOI:
https://doi.org/10.53660/792.prw2233Resumo
Dados da Organização Mundial da Saúde revelam que no ano de 2019 ocorreram 249 mil casos de leucemia, sendo este o décimo tumor mais incidente. Diante disso, foi realizada uma revisão integrativa com objetivo de analisar produções científicas sobre o uso da imunoterapia com CAR-T cells em Leucemia Linfoblástica Aguda (LLA). A análise global dos 10 estudos selecionados evidenciou alta eficácia das células CAR-T antitumorais em crianças e adultos afetados por LLA recidivantes/refratárias (r/r) com porcentagem de remissões completas variando entre 70 a 95%. Uma das principais evidências clínicas detectáveis nos estudos foi: Síndrome de Liberação de Citocinas e neurotoxicidade.
Downloads
Referências
ABBAS, Abul K.Imunologia Celular e molecular/AbulK, Abbas, Andrew H.Lichtman, Shiv Pillai; Rio de Janeiro: Elsevier, 201.
Bonifant CL, Jackson HJ, Brentjens RJ, Curran KJ. Toxicity and management in CAR T-cell therapy. Mol Ther Oncolytics. 2016 Apr 20;3:16011.
CHENG, Zhi et al. In Vivo Expansion and Antitumor Activity of Coinfused CD28- and 4-1BB-Engineered CAR-T Cells in Patients with B Cell Leukemia. Molecular therapy : the journal of the American Society of Gene Therapy, [S. l.], v. 26, n. 4, p. 976–985, 2018.
CURRAN, Kevin J. et al. Toxicity and response after CD19-specific CAR T-cell therapy in pediatric/young adult relapsed/refractory B-ALL. Blood, [S. l.], v. 134, n. 26, p. 2361–2368, 2019..
DAVILA, M. et al. “Efficacy and Toxicity Management of 19-28z CAR T Cell Therapy in B Cell Acute Lymphoblastic Leukemia”. Science Translational Medicine. New York, v. 19, n.6, p. 1-23, Dec. 2015
ENBLAD, Gunilla et al. A Phase I/IIa Trial Using CD19-Targeted Third-Generation CAR T Cells for Lymphoma and Leukemia. Clinical cancer research : an official journal of the American Association for Cancer Research, United States, v. 24, n. 24, p. 6185–6194, 2018.
Gomes-Silva D, Mukherjee M, Srinivasan M, Krenciute G, Dakhova O, Zheng Y, Cabral JMS, Rooney CM, Orange JS, Brenner MK, Mamonkin M. Tonic 4-1BB Costimulation in Chimeric Antigen Receptors Impedes T Cell Survival and Is Vector-Dependent. Cell Rep. 2017 Oct 3;21(1):17-26.
GHORASHIAN, Sara et al. Enhanced CAR T cell expansion and prolonged persistence in pediatric patients with ALL treated with a low-affinity CD19 CAR. Nature medicine, United States, v. 25, n. 9, p. 1408–1414, 2019.
HAY, K. A., Hanafi, L. A., Li, D., Gust, J., Liles, W. C., Wurfel, M. M., López, J. A., Chen, J., Chung, D., Harju-Baker, S., Cherian, S., Chen, X., Riddell, S. R., Maloney, D. G., & Turtle, C. J. Kinetics and biomarkers of severe cytokine release syndrome after CD19 chimeric antigen receptor-modified T-cell therapy. Blood, 130(21), 2295–2306. 793141 (2017).
JIANG, Huiwen et al. Anti-CD19 chimeric antigen receptor-modified T-cell therapy bridging to allogeneic hematopoietic stem cell transplantation for relapsed/refractory B-cell acute lymphoblastic leukemia: An open-label pragmatic clinical trial. American journal of hematology, United States, v. 94, n. 10, p. 1113–1122, 2019.
Kawalekar O.U, O'Connor RS, Fraietta JA, Guo L, McGettigan SE, Posey AD Jr, Patel PR, Guedan S, Scholler J, Keith B, Snyder NW, Blair IA, Milone MC, June CH. Distinct Signaling of Coreceptors Regulates Specific Metabolism Pathways and Impacts Memory Development in CAR T Cells. Immunity. 2016 Feb 16;44(2):380-90.
LIU, Y., Fang, Y., Chen, X., Wang, Z., Liang, X., Zhang, T., Liu, M., Zhou, N., et al Gasdermin E-mediated target cell pyroptosis by CAR T cells triggers cytokine release syndrome. Science immunology, 5(43), eaax7969. (2020).
MAUDE SL, Teachey DT, Porter DL, Grupp SA. CD19-targeted chimeric antigen receptor T-cell therapy for acute lymphoblastic leukemia. Blood. 2015.
Park JH, Rivière I, Gonen M, Wang X, Sénéchal B, Curran KJ, Sauter C, Wang Y, Santomasso B, Mead E, Roshal M, Maslak P, Davila M, Brentjens RJ, Sadelain M. Long-Term Follow-up of CD19 CAR Therapy in Acute Lymphoblastic Leukemia. N Engl J Med. 2018 Feb 1;378(5):449-459
PEREIRA,V.C., OLIVEIRA P.A.F. Definição das terapias celulares com receptores de antígenos quiméricos (CAR), receptores de células t (TCR) e linfócitos infiltrantes de tumor(TIL). Perspectivas futuras para a cura do cancer. Brazilian Journal Health Review. Curitiba, v. 2, n. 2, p. 6, 1105-1124, mar./apr. 2019.
RIBAS A, JEDD D. WOLCHOK Science. 2018 Mar 23; 359(6382): 1350–1355.doi: 10.1126 /science .aar4060 Published online 2018
Santomasso BD, Park JH, Salloum D, Riviere I, Flynn J, Mead E, Halton E, Wang X, Senechal B, Purdon T, Cross JR, Liu H, Vachha B, Chen X, DeAngelis LM, Li D, Bernal Y, Gonen M, Wendel HG, Sadelain M, Brentjens RJ. Clinical and Biological Correlates of Neurotoxicity Associated with CAR T-cell Therapy in Patients with B-cell Acute Lymphoblastic Leukemia. Cancer Discov, v. 8, n. 8, p. 958–971, 2018.
SHANNON L. Maude, George E Hucks, Alix Eden Seif, Mala Kiran Talekar, David T. Teachey, Diane Baniewicz, Colleen Callahan, Vanessa Gonzalez, Farzana Nazimuddin, Minnal Gupta, Noelle V. Frey, David L. Porter, Bruce L Levine, Jan J. Melenhorst, Simon F. Lacey, Carl H. June, and Stephan A. Grupp. The effect of pembrolizumab in combination with CD19-targeted chimeric antigen receptor (CAR) T cells in relapsed acute lymphoblastic leukemia (ALL).Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017) 103-103.
TOMULEASA C, Fuji S, Berce C, Onaciu A, Chira S, Petrushev B, et al. Chimeric Antigen Receptor T-Cells for the Treatment of B-Cell Acute Lymphoblastic Leukemia. Front Immunol. 2018
Turtle CJ, Hanafi LA, Berger C, Gooley TA, Cherian S, Hudecek M, Sommermeyer D, Melville K, Pender B, Budiarto TM, Robinson E, Steevens NN, Chaney C, Soma L, Chen X, Yeung C, Wood B, Li D, Cao J, Heimfeld S, Jensen MC, Riddell SR, Maloney DG. CD19 CAR-T cells of defined CD4+:CD8+ composition in adult B cell ALL patients. J Clin Invest. 2016 Jun 1;126(6):2123-38.
