AUTHOR=Shahzad Moazzam , Nguyen Andrea , Hussain Ali , Ammad-Ud-Din Mohammad , Faisal Muhammad Salman , Tariq Ezza , Ali Fatima , Butt Atif , Anwar Iqra , Chaudhary Sibgha Gull , Lutfi Forat , Ahmed Nausheen , Singh Anurag K. , Hematti Peiman , McGuirk Joseph P. , Mushtaq Muhammad Umair 

TITLE=Outcomes with chimeric antigen receptor t-cell therapy in relapsed or refractory acute myeloid leukemia: a systematic review and meta-analysis

JOURNAL=Frontiers in Immunology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1152457

DOI=10.3389/fimmu.2023.1152457

ISSN=1664-3224

ABSTRACT=<sec><title>Background</title><p>We conducted a systematic review and meta-analysis to evaluate outcomes following chimeric antigen receptor T cell (CAR-T) therapy in relapsed/refractory acute myeloid leukemia (RR-AML).</p></sec><sec><title>Methods</title><p>We performed a literature search on PubMed, Cochrane Library, and Clinicaltrials.gov. After screening 677 manuscripts, 13 studies were included. Data was extracted following PRISMA guidelines. Pooled analysis was done using the meta-package by Schwarzer et al. Proportions with 95% confidence intervals (CI) were computed.</p></sec><sec><title>Results</title><p>We analyzed 57 patients from 10 clinical trials and 3 case reports. The pooled complete and overall response rates were 49.5% (95% CI 0.18-0.81, I<sup>2 </sup>=65%) and 65.2% (95% CI 0.36-0.91, I<sup>2 </sup>=57%). The pooled incidence of cytokine release syndrome, immune-effector cell associated neurotoxicity syndrome, and graft-versus-host disease was estimated as 54.4% (95% CI 0.17-0.90, I<sup>2 </sup>=77%), 3.9% (95% CI 0.00-0.19, I<sup>2 </sup>=22%), and 1.6% (95%CI 0.00-0.21, I<sup>2 </sup>=33%), respectively.</p></sec><sec><title>Conclusion</title><p>CAR-T therapy has demonstrated modest efficacy in RR-AML. Major challenges include heterogeneous disease biology, lack of a unique targetable antigen, and immune exhaustion.</p></sec>