不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Filling the Gap: The Immune Therapeutic Armamentarium for Relapsed/Refractory Hodgkin Lymphoma.
Filling the Gap: The Immune Therapeutic Armamentarium for Relapsed/Refractory Hodgkin Lymphoma.
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尽管多年来临床进展已使霍奇金淋巴瘤(HL)成为常规化疗下最可治愈的恶性肿瘤之一,但难治和复发仍可能影响多达20-30%的患者。免疫治疗在各种肿瘤性疾病中带来的革命在该病中尤为明显,因为抗CD30抗体和检查点抑制剂已能够挽救此前无治疗选择的患者。自体造血细胞移植仍然是化疗敏感性HL治疗流程中的重要一步;然而,在接受减低强度预处理方案的患者中,异基因移植后诱导完全缓解的可能性表明其对免疫控制的敏感性。此外,过继性T细胞转移疗法的研究性应用为未来在该领域的适应证铺平了道路。在此,我们力求提供关于主导复发/难治性HL领域的新型免疫治疗药物的新鲜且最新的概述。在这一视角下,我们还将回顾肿瘤耐药的所有潜在分子机制——理论上这些机制导致治疗失败——并讨论异基因干细胞移植在新疗法时代中的地位。
Despite years of clinical progress which made Hodgkin lymphoma (HL) one of the most curable malignancies with conventional chemotherapy, refractoriness and recurrence may still affect up to 20-30% of patients. The revolution brought by the advent of immunotherapy in all kinds of neoplastic disorders is more than evident in this disease because anti-CD30 antibodies and checkpoint inhibitors have been able to rescue patients previously remaining without therapeutic options.
Autologous hematopoietic cell transplantation still represents a significant step in the treatment algorithm for chemosensitive HL; however, the possibility to induce complete responses after allogeneic transplant procedures in patients receiving reduced-intensity conditioning regimens informs on its sensitivity to immunological control.
Furthermore, the investigational application of adoptive T cell transfer therapies paves the way for future indications in this setting.
Here, we seek to provide a fresh and up-to-date overview of the new immunotherapeutic agents dominating the scene of relapsed/refractory HL. In this optic, we will also review all the potential molecular mechanisms of tumor resistance, theoretically responsible for treatment failures, and we will discuss the place of allogeneic stem cell transplantation in the era of novel therapies.
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