Systematic literature review to identify prognostic factors of efficacy and safety outcomes of chimeric antigen receptor T-Cell therapies in diffuse large B-Cell lymphoma

PURPOSE: To identify and summarize clinical factors influencing the efficacy and safety outcomes of CAR-T cell therapies in patients with diffuse large B-cell lymphoma (DLBCL) through a systematic literature review.

METHODS: We performed a systematic literature review to identify factors impacting the efficacy and safety of CAR-T therapies in DLBCL. Articles were searched in PubMed, Cochrane, and EMBASE databases. Key outcomes, including progression-free survival (PFS), overall survival (OS), complete response rate (CRR), objective response rate (ORR), duration of response (DoR), best overall response (BOR), and safety measures (e.g., Immune Effector Cell-Associated Neurotoxicity Syndrome [ICANS], and Cytokine Release Syndrome [CRS]), were extracted according to PRISMA guidelines. A total of 712 articles were identified, with 185 selected for full-text screening. Ultimately, 79 articles met inclusion criteria. Exclusions were primarily due to the absence of relevant outcome data or publication type.

RESULTS: This review highlights several factors that may influence the efficacy and safety of CAR-T therapies in DLBCL, including Eastern Cooperative Oncology Group Performance Status (ECOG PS), International Prognostic Index (IPI) score, disease histology, Ann Arbor disease stage, and elevated LDH levels.

CONCLUSION: The findings of this review can assist clinicians in refining treatment strategies and improving patient outcomes in DLBCL by incorporating these key influencing factors.