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大 B 细胞淋巴瘤的 CAR-T 细胞疗法

英文原题:CAR-T Cell Therapy in Large B Cell Lymphoma.

PubMed 2023/11/01(内容时间) Mediterr J Hematol Infect Dis Q3 · IF 2.3(JCR 2025)

研究概要

大 B 细胞淋巴瘤(LBCL)是最常见的非霍奇金淋巴瘤之一(约占 30%)。

中文摘要

大B细胞淋巴瘤(LBCL)约占非霍奇金淋巴瘤的30%,是最常见的类型之一。尽管这类淋巴瘤具有侵袭性,超过60%的患者可通过一线R-CHOP方案化学免疫治疗治愈。对于难治或复发患者,即使接受二线治疗,结局仍较差。靶向CD19的嵌合抗原受体(CAR)T细胞正成为治疗LBCL的有效二线策略。目前已有3种CD19 CAR-T产品获FDA和EMA批准。CAR-T也已用于高危LBCL一线治疗以及中枢神经系统受累患者的研究。尽管抗CD19 CAR-T改变了复发/难治性LBCL的治疗,但约60%的患者最终仍会进展或复发。因此,确定CAR-T疗效预测标准,并为CAR-T治疗后复发患者开发挽救疗法至关重要。此外,正在开展的临床试验评估同时靶向CD19和CD20或CD19和CD22的双特异性CAR-T,以提高治疗效力并减少难治或复发患者数量。

展开英文摘要原文

Large B-cell lymphomas (LBCLs) are among the most frequent (about 30%) non-Hodgkin's lymphoma. Despite the aggressive behavior of these lymphomas, more than 60% of patients can be cured with first-line chemoimmunotherapy using the R-CHOP regimen. Patients with refractory or relapsing disease show a poor outcome even when treated with second-line therapies. CD19-targeted chimeric antigen receptor (CAR) T-cells are emerging as an efficacious second-line treatment strategy for patients with LBCL. Three CD19-CAR-T-cell products received FDA and EMA approval. CAR-T cell therapy has also been explored for treating high-risk LBCL patients in the first-line setting and for patients with central nervous system involvement. Although CD19-CAR-T therapy has transformed the care of refractory/relapsed LBCL, about 60% of these patients will ultimately progress or relapse following CD19-CAR-T; therefore, it is fundamental to identify predictive criteria of response to CAR-T therapy and to develop salvage therapies for patients relapsing after CD19-CAR-T therapies. Moreover, ongoing clinical trials evaluate bispecific CAR-T cells targeting both CD19 and CD20 or CD19 and CD22 as a tool to improve the therapeutic efficacy and reduce the number of refractory/relapsing patients.

论文信息

作者
Testa U、Leone G、Pelosi E、Castelli G、Hohaus S
第一作者单位
Istituto Superiore di Sanità, Roma.Italy
通讯作者单位
Dipartimento Di Diagnostica per Immagini, Radioterapia Oncologica Ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy. Sezione Di Ematologia.Italy
文献类型
综述
期刊
Mediterranean journal of hematology and infectious diseases2023
原文标识
PubMed 38028399 · DOI 10.4084/MJHID.2023.066