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:Aggressive T-cell lymphomas: 2024: Updates on diagnosis, risk stratification, and management.
Aggressive T-cell lymphomas: 2024: Updates on diagnosis, risk stratification, and management.
侵袭性T细胞淋巴瘤的预后仍然较差。外周T细胞淋巴瘤(PTCL)有30多种不同的亚型,我们现在开始理解各种亚型之间超越组织学差异的不同之处。各种PTCL亚型的分子发病机制:基因表达谱分析和其他分子技术使我们对各种亚型差异有了更深入的理解,这反映在最新的第5版WHO PTCL分类中。越来越清楚的是,需要针对特定细胞通路的治疗方法来改善PTCL的临床结局。靶向治疗:目前有许多靶向药物处于不同阶段的PTCL临床试验中,这些药物利用了PTCL肿瘤中特定蛋白质或受体的差异表达。这包括CD30导向的抗体药物偶联物brentuximab vedotin。
侵袭性T细胞淋巴瘤的预后仍然较差。外周T细胞淋巴瘤(PTCL)有30多种不同的亚型,我们现在开始理解各种亚型之间超越组织学差异的不同之处。各种PTCL亚型的分子发病机制:基因表达谱分析和其他分子技术使我们对各种亚型差异有了更深入的理解,这反映在最新的第5版WHO PTCL分类中。越来越清楚的是,需要针对特定细胞通路的治疗方法来改善PTCL的临床结局。靶向治疗:目前有许多靶向药物处于不同阶段的PTCL临床试验中,这些药物利用了PTCL肿瘤中特定蛋白质或受体的差异表达。这包括CD30导向的抗体药物偶联物brentuximab vedotin。其他值得注意的靶点有磷脂酰肌醇3-激酶抑制剂、组蛋白去乙酰化酶抑制剂、CD25和趋化因子受体4。间变性淋巴瘤激酶(ALK)抑制剂对表达ALK的肿瘤具有前景。免疫治疗:异基因干细胞移植仍然是大多数侵袭性PTCL亚型的治愈性疗法。检查点抑制剂在PTCL治疗中的应用仍存在争议,在结外NK 细胞/T细胞淋巴瘤病例中观察到最佳结果。基于双特异性抗体的治疗和嵌合抗原受体细胞治疗正在进行临床试验。
INTRODUCTION: Aggressive T-cell lymphomas continue to have a poor prognosis. There are over 30 different subtypes of peripheral T-cell lymphoma (PTCL), and we are now beginning to understand the differences between the various subtypes beyond histologic variations. MOLECULAR PATHOGENESIS OF VARIOUS SUBTYPES OF PTCL: Gene expression profiling and other molecular techniques have enabled deeper understanding of differences in various subtypes as reflected in the latest 5th WHO classification of PTCL. It is becoming increasingly clear that therapeutic approaches that target specific cellular pathways are needed to improve the clinical outcomes of PTCL. TARGETED THERAPIES: There are many targeted agents currently in various stages of clinical trials for PTCL that take advantage of the differential expression of specific proteins or receptors in PTCL tumors. This includes the CD30 directed antibody drug conjugate brentuximab vedotin. Other notable targets are phosphatidylinositol 3-kinase inhibitors, histone deacetylase inhibitors, CD25, and chemokine receptor 4. Anaplastic lymphoma kinase (ALK) inhibitors are promising for ALK expressing tumors. IMMUNOTHERAPIES: Allogeneic stem cell transplant continues to be the curative therapy for most aggressive subtypes of PTCL. The use of checkpoint inhibitors in the treatment of PTCL is still controversial, with best results seen in cases of extranodal natural killer cell/T-cell lymphoma. Bispecific antibody-based treatments and chimeric antigen receptor cell-based therapies are in clinical trials.
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