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:Chimeric antigen receptor (CAR) T-cell treatment for mantle cell lymphoma (MCL).
Chimeric antigen receptor (CAR) T-cell treatment for mantle cell lymphoma (MCL).
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套细胞淋巴瘤(MCL)是一种罕见B细胞恶性肿瘤,复发率高,治疗仍具挑战。初治策略包括强化化疗后以自体干细胞移植(ASCT)巩固,也包括联合方案等较低强度疗法。复发患者的治疗选择包括布鲁顿酪氨酸激酶(BTK)抑制剂及其他靶向药物。新型药物如选择性BCL-2抑制剂venetoclax单药治疗难治性复发MCL时缓解率较高。利妥昔单抗、苯达莫司汀和阿糖胞苷(R-BAC)方案虽缓解率高,但缓解不持久。靶向CD19的嵌合抗原受体(CAR)T细胞产品治疗复发/难治性MCL已显示疗效。Brexucabtagene autoleucel(brexu-cel,前称KTE-X19)于2020年7月获美国食品药品监督管理局(FDA)批准,用于治疗难治和复发性MCL。本文概述复发性MCL现有管理策略,并探讨CAR-T 细胞疗法在MCL当前和未来治疗中的作用。
Mantle cell lymphoma (MCL) is a rare B-cell malignancy that remains challenging to treat with high rates of relapse. Frontline strategies range from intensive chemotherapy followed by consolidation with autologous stem cell transplant (ASCT), to less-intensive therapies including combination regimens. The treatment landscape for relapsed patients includes Bruton tyrosine kinase (BTK) inhibitors among other targeted treatments. Novel agents such as the selective BCL2 inhibitor venetoclax showed high response rates when used as monotherapy for refractory relapsed MCL.
The rituximab, bendamustine, and cytarabine (R-BAC) regimen, while response rates were high, were not durable. Chimeric antigen receptor (CAR) T-cell products targeting CD19 have been efficacious in relapsed and refractory MCL patients.
Brexucabtagene autoleucel (brexu-cel, formerly KTE-X19) was approved by US Food and Drug Administration (FDA) in July, 2020, for treatment of refractory and relapsed MCL. This article provides an overview for the available management strategies for relapsed MCL and examines the role of CAR T-cell in the current and future treatment of MCL.
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