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Cardiovascular effects associated with chimeric antigen receptor T cell therapy in cancer patients: A meta-analysis

BACKGROUND: Although numerous studies confirmed the marked efficacy of chimeric antigen receptor T cells (CAR-T cells) in many hematologic malignancies, severe cardiovascular toxicities remain to be a major obstacle when incorporating this technology. Furthermore, previous individual investigations...

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Autores principales: Chen, Li-Rong, Li, Ya-Jia, Zhang, Zheng, Wang, Ping, Zhou, Tao, Qian, Kai, Fan, Yu-Xin, Guo, Yu, He, Gong-Hao, Shen, Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682079/
https://www.ncbi.nlm.nih.gov/pubmed/36439485
http://dx.doi.org/10.3389/fonc.2022.924208
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author Chen, Li-Rong
Li, Ya-Jia
Zhang, Zheng
Wang, Ping
Zhou, Tao
Qian, Kai
Fan, Yu-Xin
Guo, Yu
He, Gong-Hao
Shen, Lei
author_facet Chen, Li-Rong
Li, Ya-Jia
Zhang, Zheng
Wang, Ping
Zhou, Tao
Qian, Kai
Fan, Yu-Xin
Guo, Yu
He, Gong-Hao
Shen, Lei
author_sort Chen, Li-Rong
collection PubMed
description BACKGROUND: Although numerous studies confirmed the marked efficacy of chimeric antigen receptor T cells (CAR-T cells) in many hematologic malignancies, severe cardiovascular toxicities remain to be a major obstacle when incorporating this technology. Furthermore, previous individual investigations regarding the cardiovascular toxicities of CAR-T cell therapy also reported controversial conclusions. Therefore, a meta-analysis was performed to further evaluate the impacts of CAR-T cell therapy on cardiovascular toxicities. METHODS: The PubMed, Embase, Web of Science, and ClinicalTrials.gov databases were searched for eligible studies up to April 2022. All analyses were carried out using the R 4.1.0 software. RESULTS: Eventually, 25 related studies consisting of 2,059 patients were enrolled in the current meta-analysis. We discovered that the pooled incidence rate of the all-cause mortality rate was 14.1% and that the pooled incidence rates of overall cardiovascular (CV) events and CV events with cytokine release syndrome (CRS) grade ≥ 2 were 25.6% and 14.2%, respectively. The pooled incidence of hypotension was 28.6%. Further analysis showed that the incidence rates of arrhythmias, cardiovascular dysfunction, heart failure (HF), CV deaths, acute coronary syndrome (ACS), cardiomyopathy, cardiac arrest, and other CV events were 19.2%, 8.0%, 5.3%, 1.8%, 2.5%, 2.9%, 1.3%, and 1.9%, respectively. CONCLUSION: Cancer patients treated with CAR-T cell therapy were at risk for cardiovascular toxicities, of which the most common cardiovascular events were arrhythmias, cardiovascular dysfunction, and heart failure. These findings would contribute to achieving more rational and individualized use of CAR-T cells in clinical treatment.
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spelling pubmed-96820792022-11-24 Cardiovascular effects associated with chimeric antigen receptor T cell therapy in cancer patients: A meta-analysis Chen, Li-Rong Li, Ya-Jia Zhang, Zheng Wang, Ping Zhou, Tao Qian, Kai Fan, Yu-Xin Guo, Yu He, Gong-Hao Shen, Lei Front Oncol Oncology BACKGROUND: Although numerous studies confirmed the marked efficacy of chimeric antigen receptor T cells (CAR-T cells) in many hematologic malignancies, severe cardiovascular toxicities remain to be a major obstacle when incorporating this technology. Furthermore, previous individual investigations regarding the cardiovascular toxicities of CAR-T cell therapy also reported controversial conclusions. Therefore, a meta-analysis was performed to further evaluate the impacts of CAR-T cell therapy on cardiovascular toxicities. METHODS: The PubMed, Embase, Web of Science, and ClinicalTrials.gov databases were searched for eligible studies up to April 2022. All analyses were carried out using the R 4.1.0 software. RESULTS: Eventually, 25 related studies consisting of 2,059 patients were enrolled in the current meta-analysis. We discovered that the pooled incidence rate of the all-cause mortality rate was 14.1% and that the pooled incidence rates of overall cardiovascular (CV) events and CV events with cytokine release syndrome (CRS) grade ≥ 2 were 25.6% and 14.2%, respectively. The pooled incidence of hypotension was 28.6%. Further analysis showed that the incidence rates of arrhythmias, cardiovascular dysfunction, heart failure (HF), CV deaths, acute coronary syndrome (ACS), cardiomyopathy, cardiac arrest, and other CV events were 19.2%, 8.0%, 5.3%, 1.8%, 2.5%, 2.9%, 1.3%, and 1.9%, respectively. CONCLUSION: Cancer patients treated with CAR-T cell therapy were at risk for cardiovascular toxicities, of which the most common cardiovascular events were arrhythmias, cardiovascular dysfunction, and heart failure. These findings would contribute to achieving more rational and individualized use of CAR-T cells in clinical treatment. Frontiers Media S.A. 2022-11-09 /pmc/articles/PMC9682079/ /pubmed/36439485 http://dx.doi.org/10.3389/fonc.2022.924208 Text en Copyright © 2022 Chen, Li, Zhang, Wang, Zhou, Qian, Fan, Guo, He and Shen https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Chen, Li-Rong
Li, Ya-Jia
Zhang, Zheng
Wang, Ping
Zhou, Tao
Qian, Kai
Fan, Yu-Xin
Guo, Yu
He, Gong-Hao
Shen, Lei
Cardiovascular effects associated with chimeric antigen receptor T cell therapy in cancer patients: A meta-analysis
title Cardiovascular effects associated with chimeric antigen receptor T cell therapy in cancer patients: A meta-analysis
title_full Cardiovascular effects associated with chimeric antigen receptor T cell therapy in cancer patients: A meta-analysis
title_fullStr Cardiovascular effects associated with chimeric antigen receptor T cell therapy in cancer patients: A meta-analysis
title_full_unstemmed Cardiovascular effects associated with chimeric antigen receptor T cell therapy in cancer patients: A meta-analysis
title_short Cardiovascular effects associated with chimeric antigen receptor T cell therapy in cancer patients: A meta-analysis
title_sort cardiovascular effects associated with chimeric antigen receptor t cell therapy in cancer patients: a meta-analysis
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682079/
https://www.ncbi.nlm.nih.gov/pubmed/36439485
http://dx.doi.org/10.3389/fonc.2022.924208
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