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:Follicular lymphoma: an update on biology and optimal therapy.
Follicular lymphoma: an update on biology and optimal therapy.
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滤泡性淋巴瘤(FL)是成熟B细胞肿瘤,病程通常惰性。遗传标志包括t(14;18)导致BCL-2过表达,以及继发遗传和表观遗传异常。早期患者通常以根治为目标,接受放疗,可联合利妥昔单抗;晚期治疗重点是延长缓解,因此无症状患者通常推迟治疗,有症状者接受免疫化疗诱导及抗体维持。值得注意的是,约五分之一患者随后出现临床进展加快,仅获短暂缓解并多次复发,即24个月内进展(POD24)。这类患者仍迫切需要更好的治疗选择。近期研究已评估多种靶向和免疫治疗,包括免疫调节药、小分子抑制剂、单抗、双特异性T细胞衔接抗体及CAR-T 产品,适用于这类复发高危患者。
Follicular lymphoma (FL) is a mature B-cell neoplasm with a mostly indolent course. Genetic hallmark characteristics are Bcl-2 overexpression based on a t(14;18) translocation and additional secondary genetic and epigenetic aberrations. Standard treatment for early-stage patients has curative intent and usually consists of radiotherapy with or without rituximab. In the advanced stage, the main therapeutic focus is on prolonged remissions.
Therefore, treatment in asymptomatic patients is usually deferred. Symptomatic patients are subject to immunochemotherapy induction followed by antibody maintenance.
Importantly, about one in five patients subsequently experiences a more rapid clinical course, achieving only short remissions with multiple relapses (POD24). In those patients, there is still an urgent need for improved therapeutic options. Accordingly, a plethora of targeted and immunotherapeutic options, including immunomodulatory drugs, small molecule inhibitors, monoclonal antibodies as well as bispecific T-cell engager antibodies and CAR-T cell products have been recently evaluated in such relapsed high-risk patients.
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