Category: Fellows Posters
Chimeric Antigen Receptor (CAR) T-cell therapy has emerged as an innovative treatment that involves genetically engineering a patient’s own T-cells to target certain malignancies. Over the past ten years, there have been advancements in understanding the safety, efficacy, and feasibility in engineering these CAR T-cells to recognize and destroy multiple cancers. The purpose of this study was to identify the trend of articles being published over the past ten years to better understand the types of malignancies being treated in clinical trials, the type of CAR T-cell therapy being engineered, and the evolution of this innovative therapy over time.
We conducted a primary literature search utilizing PubMed and EMBASE. The search terms included “CAR-T”, “chimeric antigen receptor”, and “T-cell.” Additionally, the following medical subject heading (MeSH) terms were utilized in the search: “Receptors, Chimeric Antigen” and “T-lymphocyte.” Articles were limited to clinical trials (Phase I, II, and III) between the dates of January 1st 2009 to 2019. Articles involving manufacturing, in-vitro analysis, translational studies, case reports, or pre-clinical data were excluded. The primary literature search utilizing both MeSH combinations and regular search terms yielded a total of 2202 results across both databases. All results were extracted to Microsoft Excel where repeated articles and studies not involving clinical trials were filtered out. A total of 80 articles were analyzed and 60 articles were utilized in the primary analysis after applying exclusion criteria.
A total of sixty publications were utilized in our primary analysis. Out of the sixty publications, forty-two (70 percent) were phase I clinical trials, thirteen (22 percent) phase I/II clinical trials, five (8 percent) phase II clinical trials, and zero phase III clinical trials were found. The majority of studies focused around B-cell specific malignancies including multiple myeloma, diffuse large B-cell lymphoma, non-Hodgkin lymphoma, Hodgkin lymphoma, acute lymphoblastic leukemia, chronic lymphoblastic leukemia, and follicular lymphoma. A variety of other malignancies were also studied as well as use of CAR-T in HIV patients. CD19 was the most common type of CAR-T cell therapy investigated representing 53 percent of all clinical trials. As a majority of studies were in phase I (70 percent), safety was the most common primary endpoint. 100 percent of the phase II trials that evaluated efficacy utilized response rate as the primary endpoint. 2017 had the most CAR-T clinical trial publications (30 percent).
There has been an exponential increase in CAR-T publications within the last ten years since the inception of CAR-T therapy. Most CAR-T publications investigate various B-cell malignancies. Seventy percent of published clinical trial data were Phase I studies evaluating safety. One hundred percent of Phase II studies used response rate as the primary endpoint in the evaluation of efficacy. No Phase III studies were found in the search of literature. Limitations of this study include that not every clinical trial was captured within our search as there are a plethora of ongoing clinical trials being conducted that haven’t been published.