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:A Review of Current and Pipeline Drugs for Treatment of Melanoma.
A Review of Current and Pipeline Drugs for Treatment of Melanoma.
恶性黑色素瘤是最具侵袭性的皮肤癌。
恶性黑色素瘤是最具侵袭性的皮肤癌。标准治疗方案包括手术、放疗、全身化疗、靶向治疗和免疫治疗。联合应用这些方法通常能获得更好的疗效。手术适用于局限性病例,有时包括淋巴结清扫和活检,以评估疾病播散情况。放疗有时可作为单独治疗或手术切除后的辅助治疗。全身化疗虽然应答率较低,但仍被用作联合治疗的一部分,或在其他方法失败时使用。全身化疗耐药性的产生及相关副作用促使进一步研究和临床试验探索新方法。对于晚期黑色素瘤,可能需要综合治疗方案,结合靶向治疗和免疫治疗,这些疗法显示出显著的抗肿瘤活性。靶向治疗包括针对 BRAF、MEK、c-KIT 和 NRAS 的抑制剂,旨在阻断导致肿瘤生长的特定分子。这些疗法显示出前景,尤其是在具有相应突变的患者中。联合治疗,包括 BRAF 和 MEK 抑制剂,已被证实可改善 PFS;然而,对耐药性和皮肤毒性的担忧凸显了密切监测的必要性。免疫治疗利用 TIL 和 CAR T 细胞增强免疫应答。Lifileucel 是一种获 FDA 批准的 TIL 疗法,已在晚期黑色素瘤中显示出改善的应答率。正在进行的试验继续探索 CAR T 细胞疗法对晚期黑色素瘤的疗效。靶向CTLA-4和PD-1的检查点抑制剂提高了治疗效果。新兴的IL-2疗法可增强树突状细胞,从而增强抗癌免疫。已获批用于晚期黑色素瘤的溶瘤病毒疗法在联合治疗方案中增强了治疗疗效。尽管免疫疗法显著推进了黑色素瘤的治疗,但其成功程度各不相同,这促使人们研究新药以及影响结局的因素。本综述提供了对当前黑色素瘤治疗及近期治疗进展的见解。
Malignant melanoma is the most aggressive form of skin cancer. Standard treatment options include surgery, radiation therapy, systemic chemotherapy, targeted therapy, and immunotherapy. Combining these modalities often yields better responses. Surgery is suitable for localized cases, sometimes involving lymph node dissection and biopsy, to assess the spread of the disease. Radiation therapy may be sometimes used as a standalone treatment or following surgical excision. Systemic chemotherapy, while having low response rates, is utilized as part of combination treatments or when other methods fail. The development of resistance to systemic chemotherapies and associated side effects have prompted further research and clinical trials for novel approaches. In the case of advanced-stage melanoma, a comprehensive approach may be necessary, incorporating targeted therapies and immunotherapies that demonstrate significant antitumor activity. Targeted therapies, including inhibitors targeting BRAF, MEK, c-KIT, and NRAS, are designed to block the specific molecules responsible for tumor growth. These therapies show promise, particularly in patients with corresponding mutations. Combination therapy, including BRAF and MEK inhibitors, has been evidenced to improve progression-free survival; however, concerns about resistance and cutaneous toxicities highlight the need for close monitoring. Immunotherapies, leveraging tumor-infiltrating lymphocytes and CAR T cells, enhance immune responses. Lifileucel, an FDA-approved tumor-infiltrating lymphocyte therapy, has demonstrated improved response rates in advanced-stage melanoma. Ongoing trials continue to explore the efficacy of CAR T-cell therapy for advanced melanoma. Checkpoint inhibitors targeting CTLA-4 and PD-1 have enhanced outcomes. Emerging IL-2 therapies boost dendritic cells, enhancing anticancer immunity. Oncolytic virus therapy, approved for advanced melanoma, augments treatment efficacy in combination approaches. While immunotherapy has significantly advanced melanoma treatment, its success varies, prompting research into new drugs and factors influencing outcomes. This review provides insights into current melanoma treatments and recent therapeutic advances.
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