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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Critical care management of chimeric antigen receptor T-cell therapy recipients.
Critical care management of chimeric antigen receptor T-cell therapy recipients.
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嵌合抗原受体(CAR)T细胞疗法是一种有前景的免疫治疗概念,正在改变血液系统恶性肿瘤的治疗方法。CAR-T 细胞疗法的发展代表了免疫学和细胞治疗进展成功从实验室转化到临床实践的一个典型范例。目前可用的CAR-T 细胞产品在复发/难治性急性淋巴细胞白血病和复发/难治性淋巴瘤患者中已显示出高缓解率和长期缓解。然而,CAR-T 细胞疗法可诱导严重的危及生命的毒性,如细胞因子释放综合征、神经毒性或感染,需要在重症监护病房环境中进行快速且积极的医疗处理。在这篇综述中,作者概述了CAR-T 细胞接受者中严重危及生命事件临床管理的最新进展。此外,还讨论了为最大化CAR-T 细胞安全性必须克服的关键挑战。
Chimeric antigen receptor (CAR) T-cell therapy is a promising immunotherapeutic treatment concept that is changing the treatment approach to hematologic malignancies. The development of CAR T-cell therapy represents a prime example for the successful bench-to-bedside translation of advances in immunology and cellular therapy into clinical practice. The currently available CAR T-cell products have shown high response rates and long-term remissions in patients with relapsed/refractory acute lymphoblastic leukemia and relapsed/refractory lymphoma.
However, CAR T-cell therapy can induce severe life-threatening toxicities such as cytokine release syndrome, neurotoxicity, or infection, which require rapid and aggressive medical treatment in the intensive care unit setting. In this review, the authors provide an overview of the state-of-the-art in the clinical management of severe life-threatening events in CAR T-cell recipients.
Furthermore, key challenges that have to be overcome to maximize the safety of CAR T cells are discussed.
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