肿瘤细胞治疗研究
英文原题：Optimizing Treatment for Relapsed/Refractory Classic Hodgkin Lymphoma in the Era of Immunotherapy.
大多数经典霍奇金淋巴瘤（cHL）患者通过联合化疗可获治愈，但约10-20%会复发，另有5-10%为原发难治性疾病。
大多数经典霍奇金淋巴瘤（cHL）患者通过联合化疗可获治愈，但约10-20%会复发，另有5-10%为原发难治性疾病。过去十年间，随着抗CD30抗体药物偶联物brentuximab vedotin（BV）以及PD-1抑制剂nivolumab和pembrolizumab的获批，复发/难治性（R/R）cHL的治疗格局发生了显著变化。这些药物显著拓展了自体造血细胞移植（AHCT）前挽救治疗、移植后维持治疗以及AHCT后复发治疗的选择，从而使现代治疗时代的生存率得到改善。在本综述中，我们重点介绍2023年R/R cHL的管理策略，聚焦于首次挽救治疗的选择、移植后维持治疗以及AHCT后复发的治疗。我们还讨论了老年人和不适合移植患者的管理，这些患者需要采取不同的方法。最后，我们回顾了临床试验中的新型免疫治疗策略，包括PD-1抑制剂与其他免疫激活剂的联合方案，以及新型抗体药物偶联物、双特异性抗体和细胞免疫治疗。正在进行的评估免疫治疗应答生物标志物以及循环肿瘤DNA等动态生物标志物的研究，可能进一步为治疗决策提供信息，并在未来实现更加个体化的治疗策略。
Most patients with classic Hodgkin lymphoma (cHL) are cured with combination chemotherapy, but approximately 10-20% will relapse, and another 5-10% will have primary refractory disease. The treatment landscape of relapsed/refractory (R/R) cHL has evolved significantly over the past decade following the approval of brentuximab vedotin (BV), an anti-CD30 antibody-drug conjugate, and the PD-1 inhibitors nivolumab and pembrolizumab. These agents have significantly expanded options for salvage therapy prior to autologous hematopoietic cell transplantation (AHCT), post-transplant maintenance, and treatment of relapse after AHCT, which have led to improved survival in the modern era. In this review, we highlight our approach to the management of R/R cHL in 2023 with a focus on choosing first salvage therapy, post-transplant maintenance, and treatment of relapse after AHCT. We also discuss the management of older adults and transplant-ineligible patients, who require a separate approach. Finally, we review novel immunotherapy approaches in clinical trials, including combinations of PD-1 inhibitors with other immune-activating agents as well as novel antibody-drug conjugates, bispecific antibodies, and cellular immunotherapies. Ongoing studies assessing biomarkers of response to immunotherapy and dynamic biomarkers such as circulating tumor DNA may further inform treatment decisions and enable a more personalized approach in the future.
MEMBER ACCOUNT
登录成功会直接打开下一页。
