Efficacy of Car T-Cell Therapy in Head and Neck Cancers- A Meta-Analysis

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Abstract

Background: Cancer, defined by the World Health Organization (WHO) is “a large group of diseases characterized by the growth of abnormal cells beyond their usual boundaries that can then invade adjoining parts of the body and/or spread to other organs”. From extensive surgical excisions, radiotherapy, laser therapy to immunotherapies, various treatment strategies have been proposed and implemented so far but unfortunately none could improve the five year survival rate of the patients globally. Immunotherapy, being one amongst them, is a type of cancer treatment that boosts the body’s natural defenses to fight against cancer. The current concept of immunotherapy involves Chimeric antigen receptor or the CAR T-Cell therapy which involves alterations and modifications of T cells to fight cancer cells better. Until recently, the use of CAR T-cell therapy has been restricted to small clinical trials, largely in patients with advanced blood cancers and has also shown a promising window of hope in head and neck (especially oral) cancers as well. But these treatments have nevertheless captured the attention of the people because of the remarkable responses they have produced in some patients for whom all other treatments had stopped working. The current concept of immunotherapy involves the cancer vaccines making use of CAR T-cells which are the most powerful antigen presenting cells for the induction of antigen specific T cell response. This evidence based study therefore aims to highlight the clinical perspective of CAR T-Cell based immunotherapy in oral and other head and neck cancers. Aim: Assessment of efficacy of Car T-Cell Therapy in head and neck Malignancies. Research Question: Is Car T-Cell Therapy actually effective in treating head and neck cancers? Materials and Methods: Study sample included review of 70 research articles, based on scientific data bases from the English literature based COCHRANE collaboration having a definite RCT (Randomized Control Trial). The literature was studied, analyzed and assessed; comparison was made on their p (probability) values between various techniques in terms of their sensitivity and specificity. The articles were scrutinised based on the criterion for meta-analysis and finally 11 study articles were chosen for the study. Result and Conclusion: Due to its unique individual characteristics, it helps combat against the cancer cells at its very inception. Promises a complete and permanent cure for malignancies at the grass root level. It has a sensitivity and specificity of greater than 80-90% and enhances recovery rate from 40-50% to more than 90%. So on a bulls eye view, we can say that as the already existing techniques of oral cancer treatment are very superficial and not very significant, Car T-Cell therapy tends to bring about a paradigm shift in oral cancer treatment thereby giving a new ray of hope to cancer ailing patients.
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Car - t细胞治疗头颈癌的疗效-荟萃分析
背景:世界卫生组织(世卫组织)对癌症的定义是“一大组疾病,其特征是异常细胞的生长超出其通常的边界,然后可以侵入身体的邻近部位和/或扩散到其他器官”。从广泛的手术切除、放射治疗、激光治疗到免疫治疗,各种治疗策略已经提出并实施,但不幸的是,没有一种可以提高全球患者的五年生存率。免疫疗法就是其中之一,它是一种癌症治疗方法,可以增强身体的自然防御能力来对抗癌症。目前的免疫治疗概念包括嵌合抗原受体或CAR - T细胞治疗,其中包括T细胞的改变和修饰,以更好地对抗癌细胞。直到最近,CAR - t细胞疗法的使用仅限于小型临床试验,主要用于晚期血癌患者,并且在头颈部(特别是口腔癌)癌症中也显示出希望之窗。然而,这些治疗方法还是引起了人们的注意,因为它们在一些其他所有治疗方法都无效的病人身上产生了显著的反应。目前的免疫治疗概念包括利用CAR - T细胞的癌症疫苗,CAR - T细胞是诱导抗原特异性T细胞反应的最强大的抗原提呈细胞。因此,这项基于证据的研究旨在强调基于CAR - t细胞的免疫疗法在口腔癌和其他头颈癌中的临床应用前景。目的:评价Car - t细胞治疗头颈部恶性肿瘤的疗效。研究问题:Car - t细胞疗法对头颈癌真的有效吗?材料和方法:研究样本纳入了70篇研究论文,基于COCHRANE英文文献合作的科学数据库,具有明确的RCT(随机对照试验)。对文献进行研究、分析和评估;比较了不同技术的p(概率)值的敏感性和特异性。根据荟萃分析的标准对文章进行仔细审查,最终选择了11篇研究文章进行研究。结果与结论:由于其独特的个体特性,它从一开始就有助于对抗癌细胞。承诺在基层彻底和永久治愈恶性肿瘤。灵敏度和特异度均大于80-90%,回收率由40-50%提高到90%以上。因此,从长远来看,我们可以说,由于现有的口腔癌治疗技术非常肤浅,意义不大,Car - t细胞疗法往往会带来口腔癌治疗的范式转变,从而给癌症患者带来新的希望。
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