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:Novel targeted drugs for follicular and marginal zone lymphoma: a comprehensive review.
Novel targeted drugs for follicular and marginal zone lymphoma: a comprehensive review.
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惰性非霍奇金淋巴瘤(iNHL)多数无法治愈,但属于慢性疾病,总生存期中位数接近20年。近年来,对此类淋巴瘤生物学的认识不断加深,推动了新药开发,这些药物多数不含化疗且疗效前景良好。iNHL患者确诊时中位年龄约70岁,许多人患有可能限制治疗选择的合并症。随着治疗向精准医学转变,目前面临多项挑战,包括识别用于选择治疗的预测标志物、合理安排现有疗法的序贯顺序,以及管理新出现和累积的毒性。本文介绍滤泡性淋巴瘤和边缘区淋巴瘤治疗近期进展,综述已获批及新兴疗法的数据,包括靶向治疗(PI3K、BTK和EZH2抑制剂)、单克隆抗体及抗体药物偶联物。最后,文章介绍免疫靶向策略,如联合来那度胺,以及更创新的双特异性T细胞衔接器和CAR-T 细胞疗法;这些方法可在毒性可控的情况下实现较高的持久缓解率,进一步减少化疗需求。
Although mostly incurable, indolent non-Hodgkin lymphomas (iNHL) are chronic diseases with a median overall survival approaching 20 years. In recent years, important advances in the knowledge of the biology of these lymphomas have led to the development of new drugs, mostly chemotherapy-free, with promising outcomes. With a median age of around 70 years at diagnosis, many patients with iNHL suffer from comorbid conditions that may limit treatment options.
Therefore, nowadays, in the transition towards personalized medicine, several challenges lie ahead, such as identifying predictive markers for the selection of treatment, the adequate sequencing of available therapies, and the management of new and accumulated toxicities. In this review, we include a perspective on recent therapeutic advances in follicular and marginal zone lymphoma.
We describe emerging data on approved and emerging novel therapies, such as targeted therapies (PI3K inhibitors, BTK inhibitors, EZH2 inhibitors), monoclonal antibodies and antibody-drug conjugates.
Finally, we describe immune-directed approaches such as combinations with lenalidomide or the even more innovative bispecific T-cell engagers and chimeric antigen receptor T-cell therapy, which can achieve a high rate of durable responses with manageable toxicities, further obviating the need for chemotherapy.
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