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:Management of chimeric antigen receptor T-cell induced cytokine release syndrome: Current and emerging approaches.
Management of chimeric antigen receptor T-cell induced cytokine release syndrome: Current and emerging approaches.
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与CAR-T 细胞治疗相关的最常见不良事件是细胞因子释放综合征,其特征为不同程度严重性的发热、低氧和低血压。在严重情况下,细胞因子释放综合征可导致危及生命的症状,如多器官衰竭。细胞因子释放综合征管理广泛接受的一线治疗是tocilizumab联合或不联合皮质类固醇,但关于对该方案无反应患者的适当管理指导非常有限。新兴策略通过新机制靶向细胞因子释放综合征,在治疗或预防严重细胞因子释放综合征方面显示出前景。尽管需要进一步的临床研究来评估这些新兴方法的适用性,但这些探索性疗法可能塑造CAR-T 细胞诱导的细胞因子释放综合征管理的未来格局。本综述文章全面概述了当前和新兴的CAR-T 细胞诱导的细胞因子释放综合征管理疗法,特别是对tocilizumab和类固醇难治的病例。
The most common adverse event associated with chimeric antigen receptor T-cell therapy is cytokine release syndrome, which is characterized by fever, hypoxia, and hypotension in varying degrees of severity. In severe cases, cytokine release syndrome can result in life-threatening symptoms such as multi-organ failure. The widely accepted first-line therapy for cytokine release syndrome management is tocilizumab with or without corticosteroids, but there is very limited guidance on the proper management of patients unresponsive to this regimen.
There are emerging strategies that target cytokine release syndrome through novel mechanisms, showing promise in treating or preventing severe cytokine release syndrome. Although further clinical investigation is necessary to assess the applicability of the emerging approaches, these exploratory therapies may shape the future landscape of chimeric antigen receptor T-cell induced cytokine release syndrome management.
This review article provides a comprehensive overview of the current and emerging therapies for the management of chimeric antigen receptor T-cell induced cytokine release syndrome, especially cases that are refractory to tocilizumab and steroids.
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