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:CAR T-Based Therapies in Lymphoma: A Review of Current Practice and Perspectives.
CAR T-Based Therapies in Lymphoma: A Review of Current Practice and Perspectives.
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采用现代一线化学免疫治疗方案后,超过半数非霍奇金淋巴瘤(NHL)患者可以治愈;但复发和/或难治性疾病患者后续治疗的结局仍较差,尤其是无法接受造血干细胞移植者。因此,复发/难治性NHL患者仍有很大的未满足医疗需求。过继免疫治疗已部分填补这一治疗缺口。靶向CD19的自体嵌合抗原受体(auto-CAR)T细胞,彻底改变了复发/难治性B细胞恶性肿瘤的治疗。该人群中已取得显著的缓解率和持久缓解,促使美国食品药品监督管理局(FDA)于2017至2021年间批准了四种CAR-T 细胞产品。这一前所未有的成功在全球引发广泛关注,自体CAR-T 细胞现已开始前移至大B细胞淋巴瘤更早的治疗线次。本文总结靶向CD19的自体CAR-T 细胞治疗现行实践与最新进展,以及特定毒性的管理,并讨论异基因CAR-T 开发在这一治疗领域中的定位。
While more than half of non-Hodgkin lymphomas (NHL) can be cured with modern frontline chemoimmunotherapy regimens, outcomes of relapsed and/or refractory (r/r) disease in subsequent lines remain poor, particularly if considered ineligible for hematopoietic stem cell transplantation. Hence, r/r NHLs represent a population with a high unmet medical need. This therapeutic gap has been partially filled by adoptive immunotherapy.
CD19-directed autologous chimeric antigen receptor (auto-CAR) T cells have been transformative in the treatment of patients with r/r B cell malignancies. Remarkable response rates and prolonged remissions have been achieved in this setting, leading to regulatory approval from the U. S. Food and Drug Administration (FDA) of four CAR T cell products between 2017 and 2021. This unprecedented success has created considerable enthusiasm worldwide, and autologous CAR T cells are now being moved into earlier lines of therapy in large B cell lymphoma.
Herein, we summarize the current practice and the latest progress of CD19 auto-CAR T cell therapy and the management of specific toxicities and discuss the place of allogeneic CAR T development in this setting.
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