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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Role of minimal residual disease assessment in multiple myeloma.
Role of minimal residual disease assessment in multiple myeloma.
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多发性骨髓瘤(MM)是一种以浆细胞克隆性增殖为特征的血液系统恶性肿瘤。MM 是一种异质性疾病,具有多种分子亚型,预后各不相同。随着包括单克隆抗体、双特异性 T 细胞衔接器和CAR-T 细胞(CAR-T 细胞)在内的非常有效疗法的出现,大多数 MM 患者现在生存期延长。然而,该疾病仍然无法治愈,一部分高危患者仍持续出现早期复发和短生存期。已开发出新型高灵敏度方法,可在治疗期间或治疗后检测微小残留病(MRD)。在前瞻性随机临床试验和真实世界环境中,达到 MRD 阴性均是一个强有力的独立预后因素。虽然 MRD 评估现已成为临床试验中经过验证的终点,但其在临床实践中的应用尚未确立,其指导治疗的潜在影响仍在深入评估中。在此,我们讨论可用于 MRD 评估的不同方法以及 MRD 评估在 MM 管理中的作用。
Multiple myeloma (MM) is a hematologic malignancy characterized by clonal proliferation of plasma cells. MM is a heterogeneous disease, featured by various molecular subtypes with different outcomes. With the advent of very efficient therapies including monoclonal antibodies, bispecific T-cell engagers and chimeric antigen receptor T cells (CAR T cells), most MM patients now have a prolonged survival.
However, the disease remains incurable, and a subgroup of high-risk patients continue to have early relapse and short survival. Novel and highly sensitive methods have been developed allowing the detection of minimal residual disease (MRD) during or after treatment.
Achievement of MRD negativity is a strong and independent prognostic factor in both prospective randomized clinical trials and in the real-world setting. While MRD assessment is now a validated endpoint in clinical trials, its incorporation in clinical practice is not yet established and its potential impact on guiding therapy remains under in-depth evaluation.
Here we discuss the different methods available for MRD assessment and the role of MRD evaluation in MM management.
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