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:Glofitamab Treatment in Relapsed or Refractory DLBCL after CAR T-Cell Therapy.
Glofitamab Treatment in Relapsed or Refractory DLBCL after CAR T-Cell Therapy.
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对于既往接受两线治疗后仍难治或复发的弥漫大 B 细胞淋巴瘤(DLBCL)患者,CAR-T 细胞治疗已成为标准治疗选择。对于 CAR-T 治疗后复发患者,目前治疗建议的证据有限,且这类患者预后较差。
本研究评估双特异性 CD20×CD3 抗体 glofitamab 单药治疗 CAR-T 后进展患者的安全性和疗效。研究报告了连续入组的 9 例既往接受 CAR-T 治疗后进展的 DLBCL 患者。患者在单次 obinutuzumab 预处理后,于一家学术医疗中心接受最多 12 个周期的 glofitamab。2 例患者发生 CRS,均为 2 级。总缓解率为 67%;4 例达到完全缓解,另有 2 例部分缓解。有趣的是,在 5 例可检测到 CAR-T 细胞的患者中,3 例外周血循环 CAR-T 细胞的持续存在时间延长。结果提示,glofitamab 对 CAR-T 治疗后复发的 DLBCL 患者耐受性良好且有效,并可能增强残余 CAR-T 细胞活性。
Chimeric antigen receptor T-cells (CAR T) treatment has become a standard option for patients with diffuse large B-cell lymphomas (DLBCL), which are refractory or relapse after two prior lines of therapy.
However, little evidence exists for treatment recommendations in patients who relapse after CAR T-cell treatment and the outcome for such patients is poor. In this study, we evaluated the safety and efficacy of a monotherapy with the bispecific CD20xCD3 antibody glofitamab in patients who progressed after CAR T treatment.
We report nine consecutive patients with progressive DLBCL after preceding CAR T-cell therapy. The patients received a maximum of 12 cycles of glofitamab after a single obinutuzumab pre-treatment at an academic institution. CRS was observed in two patients (grade 2 in both patients).
We observed an overall response rate of 67%, with four patients achieving a complete response and a partial remission in two patients. Interestingly, we identified increased persistence of circulating CAR T-cells in peripheral blood in three of the five patients with measurable CAR T-cells.
Our data suggest that glofitamab treatment is well tolerated and effective in patients with DLBCL relapsing after CAR T-cell therapy and can enhance residual CAR T-cell activity.
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