CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Rituximab-Lenalidomide-Ibrutinib Combination for Relapsed/Refractory Primary CNS Lymphoma: A Case Series of the LOC Network.
Rituximab-Lenalidomide-Ibrutinib Combination for Relapsed/Refractory Primary CNS Lymphoma: A Case Series of the LOC Network.
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R 2 I 联合方案在预后不良、既往接受大量治疗的患者中产生了高比例的快速起效缓解,毒性可控,并使 3 例患者得以进入巩固治疗。
评估利妥昔单抗-来那度胺-伊布替尼(R²I)联合方案治疗复发/难治性(R/R)原发性中枢神经系统淋巴瘤(PCNSL)的疗效和耐受性。
从法国LOC数据库中回顾性筛选并分析接受R²I治疗的R/R PCNSL患者。
共14例患者接受R²I治疗,中位年龄63岁,Karnofsky体能状态评分中位数为75%;治疗前既往化疗中位数为2线,其中5例曾接受自体干细胞移植(ASCT)。最佳疗效为完全缓解4/14例、部分缓解4/14例,中位起效时间为2.5个月。3名应答患者在R²I治疗后接受巩固治疗(全脑放疗2例,ASCT 1例);另有1例将R²I作为CAR-T 治疗前的桥接方案。3/14例患者因毒性停用R²I,未发生毒性相关死亡。讨论:对于既往接受多线治疗、预后较差的患者,R²I联合方案可快速诱导较高缓解率,毒性可控,并使3名患者得以继续接受巩固治疗。尽管结果仍属初步,但支持在常规化疗失败的R/R PCNSL患者中使用R²I。证据等级:本研究提供Ⅳ级证据,表明利妥昔单抗、来那度胺和伊布替尼联合可使既往多线治疗的R/R PCNSL患者获得较高缓解率。
R/R PCNSL patients treated with R 2 I were retrospectively selected and analyzed from the French LOC database.
Fourteen patients (median age: 63 years, median Karnofsky Performance Status: 75%) received R 2 I, administered after a median of 2 previous lines of chemotherapy, including autologous stem cell transplantation (ASCT) in 5 cases. The best response was complete response in 4/14 patients and partial response in 4/14 patients, achieved in a median of 2.5 months. Three responder patients received consolidation treatment (WBRT: N = 2, ASCT: N = 1) after R 2 I, and R 2 I served as a bridge before CAR-T cell therapy for one patient. R 2 I was discontinued due to toxicity in 3/14 patients. There were no toxicity-related deaths. DISCUSSION: The R 2 I combination resulted in a high rate of response of rapid-onset in heavily pretreated patients with poor prognosis, with manageable toxicity, and allowed 3 patients to proceed to consolidation. Although preliminary, these results support the use of R 2 I for R/R PCNSL failing conventional chemotherapies. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that combination of rituximab-lenalidomide-ibrutinib induces a high rate of response in heavily pretreated R/R PCNSL.
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