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东南亚和南亚应用新型 CAR-T 细胞治疗优化淋巴瘤患者管理的独特中心辐射模式

英文原题:A unique hub-and-spoke model to optimize patient management in lymphoma using novel CAR-T cell therapy in Southeast and South Asia.

查看英文原题

A unique hub-and-spoke model to optimize patient management in lymphoma using novel CAR-T cell therapy in Southeast and South Asia.

PubMed 2022/09/01(内容时间) Hematol Oncol Q1 · IF 4.1(JCR 2025)

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中文摘要

癌症新疗法为患者及其家庭带来希望,尤其是在癌症对已确立方案无应答时。CAR-T 细胞治疗改变了复发/难治性淋巴瘤治疗模式,通过基因改造T细胞表面受体,增强患者自身T细胞检测并清除癌细胞的能力。建立治疗中心并培养该新型治疗策略的临床专业能力流程复杂,需要时间、资源以及将卫生预算投入新领域的决心。目前,新加坡是东南亚和南亚唯一获得CAR-T 产品tisagenlecleucel上市许可的国家。跨境提供CAR-T 治疗,使邻国患者获得更多治疗选择。本文介绍新加坡与邻国之间独特的枢纽-辐射式跨境合作,以便复发/难治性淋巴瘤患者获得CAR-T 细胞疗法。截至2022年,已有4例患者纳入该跨境CAR-T 治疗合作。患者在新加坡停留至少2个月,包括治疗前评估、单采、CAR-T 细胞输注和治疗后监测。转诊和治疗医生对患者的支持对合作成功至关重要,具体包括早期沟通、患者筛选、多学科照护、治疗后监测和细节管理。本文讨论患者治疗历程,以及这一独特合作模式的开发和实施。

展开英文摘要原文

Novel therapeutic options for cancer offer hope for patients and their families, particularly when the cancer has not responded to established treatment regimens. The CAR-T cell therapeutic approach has changed the treatment paradigm for relapsed or refractory lymphoma, extending the capacity of the patient's own T cells to detect and eliminate cancer cells through genetic modification of T-cell surface receptors. The process of establishing treatment centers and developing clinical expertize in this novel treatment strategy is complex. Time, resources, and a commitment to focusing health budgets on a new area are required. Currently, Singapore is the only country in southeast and south Asia with market authorization of the CAR-T product, tisagenlecleucel. Availability of CAR-T treatment across international borders provides patients in neighboring countries with choice in therapeutic options.

This paper describes the unique hub-and-spoke cross-border collaboration developed between Singapore and its neighbors to provide access to CAR-T cell therapy for patients with relapsed or refractory lymphoma. To date in 2022, four patients have been included in the CAR-T treatment cross-border collaboration. Their stay in Singapore has been at least 2 months' duration, including the pre-treatment evaluation, apheresis, CAR-T cell infusion and post-treatment monitoring.

Patient support from referring and treating physicians, critical to the success of the undertaking, is characterized by early communication, patient selection, multi-disciplinary care, post-treatment monitoring, and attention to detail. The patient journey and the development and implementation of this unique collaboration are discussed.

论文信息

作者
Wei Inng Lim FL、Yunxin C、Huang FJ、Khee Hwang WY
单位
Singapore General Hospital, Singapore, Singapore.Singapore
期刊
Hematological oncology2022 Sep
原文标识
PubMed 36047631 · DOI 10.1002/hon.3065