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Outcomes of Wild Type and TP53‐Mutated B Cell Malignancy Patients Receiving CAR‐T Cell Therapy: A Systematic Review and Meta‐Analysis
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Outcomes of Wild Type and TP53‐Mutated B Cell Malignancy Patients Receiving CAR‐T Cell Therapy: A Systematic Review and Meta‐Analysis
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Outcomes of Wild Type and TP53‐Mutated B Cell Malignancy Patients Receiving CAR‐T Cell Therapy: A Systematic Review and Meta‐Analysis
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Journal Article
Outcomes of Wild Type and TP53‐Mutated B Cell Malignancy Patients Receiving CAR‐T Cell Therapy: A Systematic Review and Meta‐Analysis
2025
Overview
P53 mutation (TP53m) is a common intrinsic factor involved in relapsed or refractory (R/R) B cell malignancies that associates with treatment resistance. As a novel immunotherapy, CAR‐T has been increasingly applied in TP53m B cell malignancies, yet whether it can overcome the poor outcome of the TP53m population is controversial. We searched MEDLINE and EMBASE to identify population‐based cohort studies that evaluated the CAR‐T treatment outcomes between wild type and TP53m patients in B cell malignancies. Meta‐analysis on their complete response (CR), partial response (PR), overall response rate (ORR), progression‐free survival (PFS) and overall survival (OS) was carried out and pooled risk ratios (RR) or hazard ratios (HR) were estimated. A total of 10 eligible studies reporting 848 patients with B cell malignancies from wild type and TP53m groups receiving CAR‐T therapy were selected. The CR and ORR were comparable in both wild type and TP53m patients either with B cell lymphoma or leukaemia (all p > 0.05). However, the TP53m group was associated with shorter PFS and OS in both diseases (all p < 0.05). In traditional single targeting CAR‐T therapy, the PFS and OS were shorter in the TP53m group than in the wild type group (all p < 0.05). In contrast, the former outcomes of the wild type and TP53m groups were comparable when receiving dual‐targeting CAR‐T treatment (all p > 0.05). Though the CR and ORR of wild type and TP53m groups were similar, the PFS and OS of B cell malignancy patients bearing TP53m were inferior to wild type patients receiving CAR‐T cell treatment. Notably, the CR, PFS and OS of wild type and TP53m groups exhibit the same therapeutic effect via CD19/22 CAR‐T cocktail therapy. In other words, the poor prognosis of TP53m patients may be overcome by double targeting CAR‐T mode.
Publisher
John Wiley & Sons, Inc
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