肿瘤细胞治疗研究
英文原题：Mantle Cell Lymphoma: the Role of Risk-Adapted Therapy and Treatment of Relapsed Disease.
在本综述中，我们概述了当前的治疗策略，讨论了正在发展的药物，并为治疗R/R MCL提供了指导。
综述目的：回顾当前治疗策略，讨论正在发展的药物，并为复发/难治性套细胞淋巴瘤（R/R MCL）的治疗提供指导。 最新进展：靶向治疗、包括嵌合抗原受体（CAR）T 细胞疗法和造血干细胞移植（HSCT）在内的细胞疗法，以及非共价 BTK 抑制剂、双特异性抗体和抗体药物偶联物等新型药物，推动了难治或复发 MCL 治疗的发展。MCL 是一种预后较差的成熟 B 细胞淋巴瘤。当前治疗包括免疫化疗、化疗和自体干细胞移植（SCT）；这些方法可使患者缓解，但随后可能复发。对化疗敏感且缓解持续至少超过 2 年的患者，或存在化疗禁忌的患者，可采用化疗药物联合 rituximab 的化学免疫治疗作为过渡，衔接更具根治性的治疗。蛋白酶体抑制剂和免疫调节剂（如 bortezomib 和 lenalidomide）可单药或联合使用。ibrutinib、acalabrutinib 和 zanubrutinib 等 Bruton 酪氨酸激酶（BTK）抑制剂已证实可用于 R/R 疾病。另一种强效药物 venetoclax 可用于 BTK 抑制剂治疗后进展或不耐受的 MCL。MCL 管理的新进展包括细胞疗法，如 CAR T 细胞疗法和 SCT，可供经多线治疗后进展的健康年轻患者（<65 岁）选择。疾病进展过程中会获得导致治疗耐药的突变。非共价 BTK 抑制剂、双特异性抗体和抗体药物偶联物等新药正在推动 R/R MCL 治疗进步。R/R MCL 是复杂疾病，治疗选择众多，但尚无头对头比较证实某一种优于其他方案。本文回顾当前治疗策略、讨论新兴药物，并为 R/R MCL 治疗提供指导。
PURPOSE OF REVIEW: In this review, the current treatment strategies are recapped, evolving agents are discussed, and we provide guidance in treating R/R MCL. RECENT FINDINGS: There has been an advancement in treatment using targeted therapy, cellular therapies including chimeric antigen receptor (CAR) T cell therapy and hematopoietic stem cell transplantation (HSCT) and novel therapeutic agents including non-covalent BTKis, bispecific antibodies, and antibody-drug conjugates for treatment of refractory and relapsed mantle cell lymphoma. Mantle cell lymphoma (MCL) is a mature B-cell lymphoma that is associated with a poor prognosis. Current treatments include immunochemotherapy, chemotherapy and autologous stem cell transplantation (SCT) which place patients in remission but result in relapse. Chemoimmunotherapy uses chemotherapeutic agents paired with rituximab in patients who have chemo-sensitive disease with prolonged remission of at least > 2 years and/or have contraindications to chemotherapy that serve as bridges to more definitive treatment. Additional therapies including proteosome inhibitor-based therapies and immunomodulators, like bortezomib and lenalidomide, can be used as single agents or in combination with others. Bruton's tyrosine kinase (BTK) inhibitors including ibrutinib, acalaburtinib, and zanubrutinib have also been proven effective for the treatment of (R/R) disease. Another agent is Venetoclax, a robust drug that can be used in MCL after progression or intolerance to BTKi. Newer advances in the management of MCL have led to the utilization of cellular therapies including chimeric antigen receptor (CAR) T cell therapy and SCT that are options for healthy young (< 65 years old) who have progressed through several lines of therapies. With progression of disease, mutations are acquired that cause therapy resistance. Novel therapeutic agents such as non-covalent BTKis, bispecific antibodies, and antibody-drug conjugates are paving the way for advancements in treatment for R/R MCL. R/R MCL is a complex disease with many therapeutic options none of which has been proven superior in head-to-head comparison. In this review, the current treatment strategies are recapped, evolving agents are discussed, and we provide guidance in treating R/R MCL.
MEMBER ACCOUNT
登录成功会直接打开下一页。
