决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Neurotoxicity of Cancer Immunotherapies Including CAR T Cell Therapy.
Neurotoxicity of Cancer Immunotherapies Including CAR T Cell Therapy.
新型免疫疗法呈指数级增长,已改变了肿瘤治疗的格局。
综述目的:概述获批免疫疗法及关键临床试验中观察到的神经毒性谱,包括免疫检查点抑制剂、CAR-T 细胞疗法、疫苗疗法和溶瘤病毒。近期发现:新型免疫疗法呈指数级增长,已改变肿瘤治疗格局。随着癌症免疫治疗应用更加广泛,人们对相关神经毒性的特征描述不断深入,潜在机制研究也取得进展,并制定了管理指南。对长期神经系统后遗症的关注亦日益增加。免疫治疗的神经系统并发症可影响中枢及周围神经系统的各个方面。早期识别和治疗至关重要。免疫治疗适应证扩展至实体瘤和中枢神经系统肿瘤后,也带来了新的挑战,例如如何可靠地区分神经毒性与疾病进展。我们对免疫治疗神经毒性的认识不断加深,凸显了未来重要研究方向以及开发新型免疫调节疗法的必要性。
PURPOSE OF REVIEW: To outline the spectrum of neurotoxicity seen with approved immunotherapies and in pivotal clinical trials including immune checkpoint inhibitors, chimeric antigen receptor T-cell therapy, vaccine therapy, and oncolytic viruses. RECENT FINDINGS: There has been an exponential growth in new immunotherapies, which has transformed the landscape of oncology treatment. With more widespread use of cancer immunotherapies, there have also been advances in characterization of its associated neurotoxicity, research into potential underlying mechanisms, and development of management guidelines. Increasingly, there is also mounting interest in long-term neurologic sequelae. Neurologic complications of immunotherapy can impact every aspect of the central and peripheral nervous system. Early recognition and treatment are critical. Expanding indications for immunotherapy to solid and CNS tumors has led to new challenges, such as how to reliably distinguish neurotoxicity from disease progression. Our evolving understanding of immunotherapy neurotoxicity highlights important areas for future research and the need for novel immunomodulatory therapeutics.
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