决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Hepatitis B virus and hepatitis C virus reactivation in cancer patients receiving novel anticancer therapies.
应制定针对风险评估、监测和管理的具体策略,以降低慢性 HBV 或 HCV 感染患者在接受新型抗肿瘤治疗后病毒再激活的风险。
背景:合并乙型肝炎病毒(HBV)或丙型肝炎病毒(HCV)感染的癌症患者在接受癌症治疗后病毒再激活风险较高。然而,对于接受免疫检查点抑制剂、布鲁顿酪氨酸激酶(BTK)抑制剂、靶向CD22、CD38或CC趋化因子受体4(CCR4)的药物,以及嵌合抗原受体(CAR)T细胞疗法等新型抗癌药物的患者,HBV或HCV再激活数据有限。 目的:本文叙述性综述描述接受新型全身性抗癌治疗患者HBV和HCV再激活的发生率、特征及结局。 资料来源:检索MEDLINE数据库,查找2013年7月至2021年12月以英语发表的原始研究、病例报告和系统综述,涉及合并HBV或HCV感染并接受新型全身性抗癌治疗的患者。 内容:接受免疫检查点抑制剂(durvalumab、atezolizumab、nivolumab、pembrolizumab、ipilimumab和tremelimumab)、BTK抑制剂(ibrutinib和acalabrutinib)、靶向CD22(inotuzumab ozogamicin)、CD38(daratumumab、isatuximab)或CCR4(mogamulizumab)药物,以及CAR T细胞疗法(axicabtagene ciloleucel)的癌症患者,HBV或HCV再激活风险尚未明确。但建议筛查慢性HBV和HCV感染,并在新型抗癌治疗期间常规监测感染患者,以便尽早发现病毒再激活;病毒再激活可能影响肿瘤治疗结局,甚至致命。 意义:应制定具体的风险评估、监测和管理策略,以降低慢性HBV或HCV感染患者接受新型抗癌治疗后的病毒再激活风险。
BACKGROUND: Cancer patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are at high risk of viral reactivation after cancer treatment. However, there is a paucity of data regarding HBV or HCV reactivation in cancer patients who receive newer anticancer drugs such as immune checkpoint inhibitors; Bruton tyrosine kinase (BTK) inhibitors; agents targeting CD22, CD38, and CC chemokine receptor 4 (CCR4); and chimeric antigen receptor (CAR) T-cell therapies. OBJECTIVES: In this narrative review article, we describe the rate, characteristics, and outcomes of HBV and HCV reactivation in patients receiving novel systemic anticancer therapies. SOURCES: We searched MEDLINE for all original research articles, case reports, and systematic reviews published in English between July 2013 and December 2021 on cancer patients with HBV or HCV infection receiving novel systemic anticancer therapy. CONTENT: The risk of HBV or HCV reactivation is not well defined in cancer patients receiving immune checkpoint inhibitors (durvalumab, atezolizumab, nivolumab, pembrolizumab, ipilimumab, and tremelimumab); BTK inhibitors (ibrutinib and acalabrutinib); agents targeting CD22 (inotuzumab ozogamicin), CD38 (daratumumab, isatuximab), and CCR4 (mogamulizumab); and CAR T-cell therapy (axicabtagene-ciloleucel). However, screening for chronic HBV and HCV infections and routine monitoring of patients with such infections during novel anticancer therapy are recommended for early identification of viral reactivation, which can impact outcomes of oncologic treatment or be fatal. IMPLICATIONS: Specific strategies for risk assessment, monitoring, and management should be designed to reduce the risk of reactivation after novel anticancer therapy in patients with chronic HBV or HCV infections.
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