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:Role of FDG PET/CT in Patients With Lymphoma Treated With Chimeric Antigen Receptor T-Cell Therapy: Current Concepts.
Role of FDG PET/CT in Patients With Lymphoma Treated With Chimeric Antigen Receptor T-Cell Therapy: Current Concepts.
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嵌合抗原受体(CAR)T细胞疗法是一种细胞疗法,通过增强患者T细胞识别并结合特定肿瘤抗原的能力发挥作用。CAR-T 细胞疗法最初为治疗白血病而开发,目前主要适应证为复发/难治性非霍奇金淋巴瘤。FDG PET/CT在代谢活跃型淋巴瘤患者的诊断、分期、治疗应答评估及复发评价中具有基础性作用。与其在淋巴瘤管理中的作用一致,FDG PET/CT也是CAR-T 治疗前后评估患者的首选影像学检查;支持其在此情境下应用的证据不断增加。本文综述淋巴瘤患者CAR-T 治疗的当前认识,强调治疗前后FDG PET/CT的关键作用。文中提出一个框架,在CAR-T 治疗过程中于4个时间点进行FDG PET/CT:治疗前基线检查(在决定实施CAR-T 时进行,并在任何桥接治疗后再次检查),以及输注后1个月和3个月检查。这些时间点评估的PET参数可预测多种患者结局。
Chimeric antigen receptor (CAR) T-cell therapy is a cellular therapy in which the patient's T cells are enhanced to recognize and bind to specific tumor antigens. CAR T-cell therapy was initially developed for the treatment of leukemia, but its current main indication is the treatment of relapsed or refractory non-Hodgkin lymphoma. FDG PET/CT plays a fundamental role in the diagnosis, staging, therapy response assessment, and recurrence evaluation of patients with metabolically active lymphoma. Consistent with the examination's role in lymphoma management, FDG PET/CT is also the imaging modality of choice to evaluate patients before and after CAR T-cell therapy, and evidence supporting its utility in this setting continues to accumulate.
In this article, we review current concepts in CAR T-cell therapy in patients with lymphoma, emphasizing the critical role of FDG PET/CT before and after therapy. A framework is presented that entails performing FDG PET/CT at four time points over the course of CAR T-cell therapy: pretherapy at baseline at the time of decision to administer CAR T-cell therapy and after any bridging therapies and posttherapy 1 and 3 months after infusion. PET parameters assessed at these time points predict various patient outcomes.
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