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优化高危复发/难治性 (r/r) 滤泡性淋巴瘤 (FL) 的 CAR-T 细胞治疗真实世界结局:视频播客与病例示例

英文原题:Optimizing Real-World Outcomes in High-Risk Relapsed/Refractory (r/r) FL with CAR-T Cell Therapy: A Vodcast and Case Example.

查看英文原题

Optimizing Real-World Outcomes in High-Risk Relapsed/Refractory (r/r) FL with CAR-T Cell Therapy: A Vodcast and Case Example.

PubMed 2024/03/21(内容时间) Oncol Ther Q2 · IF 3.4(JCR 2025)

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中文摘要

滤泡性淋巴瘤(FL)通常被认为是一种慢性疾病,伴有频繁复发,每次复发都会缩短缓解持续时间和生存期。在治疗时间轴上的正确时机选择最合适的治疗是优化结局的关键。本期vodcast由Kai Hübel博士主讲,旨在通过一个患者病例概述FL的严重性,并强调嵌合抗原受体(CAR)-T细胞是复发/难治性(r/r)FL的有效治疗。该患者50岁出头,于2010年代初诊断为FL,表现为第三次复发。患者主诉盗汗和乏力,但仍能自我照料(东部肿瘤协作组体能状态评分2)。患者接受了8个周期的利妥昔单抗-环磷酰胺-多柔比星-长春新碱-泼尼松龙(R-CHOP),随后接受放疗和利妥昔单抗维持治疗(一线),之后接受利妥昔单抗每周4次,随后利妥昔单抗维持治疗(二线)。患者在利妥昔单抗维持治疗期间复发;患者为利妥昔单抗难治。患者接受了6个周期的苯达莫司汀/奥妥珠单抗,随后奥妥珠单抗维持治疗。患者在奥妥珠单抗维持治疗期间复发,放疗后达到部分缓解,并换用R/来那度胺。由于存在若干高危特征,启动了CAR-T 细胞治疗。Hübel博士强调,对该患者而言,更早接受CAR-T 细胞治疗本会更有益。ELARA试验以及比较性研究的结果显示,在经大量既往治疗的r/r FL(包括高危患者)中,tisagenlecleucel比标准治疗更有效。

总之,CAR-T 细胞疗法对于多线 r/r FL 患者是一种有前景的治疗选择。本文提供视频播客功能。

展开英文摘要原文

Follicular lymphoma (FL) is often considered a chronic disease with frequent relapses, shortening both response duration and survival after every relapse. Selecting the most appropriate therapy at the right time within the treatment timeline is key to optimize outcomes. The aim of this vodcast, featuring Dr. Kai H bel, is to outline the severity of FL by referring to a patient case as well as highlight chimeric antigen receptor (CAR)-T cells as an effective therapy in relapsed/refractory (r/r) FL. The patient was in their early 50s, diagnosed with FL in the early 2010s and presented with a third relapse. The patient complained of night sweats and fatigue but was still capable of self-care (Eastern Cooperative Oncology Group Performance Status Scale 2).

The patient received eight cycles of rituximab-cyclophosphamide-doxorubicin-vincristine-prednisolone (R-CHOP), followed by irradiation and rituximab maintenance (first-line) and then received rituximab 4 weekly, followed by rituximab maintenance (second-line). The patient relapsed during rituximab maintenance; the patient was rituximab refractory. The patient received six cycles of bendamustine/obinutuzumab followed by obinutuzumab maintenance.

The patient relapsed during obinutuzumab maintenance, achieved a partial remission after irradiation and was switched to R/lenalidomide. Due to several high-risk features, CAR-T cell therapy was initiated. Dr. Hubel underlines how earlier treatment with CAR-T cell therapy would have been beneficial for this patient. Results of the ELARA trial as well as comparative studies have shown tisagenlecleucel to be more effective than standard of care in extensively pretreated r/r FL, including high-risk patients.

In conclusion, CAR-T cell therapy is a promising therapy option for patients with multiply r/r FL. A vodcast feature is available for this article.

论文信息

作者
Hübel K
单位
Department I of Internal Medicine, Faculty of Medicine, University Hospital Cologne, Cologne, Germany. Kai.huebel@uk-koeln.de.Germany
期刊
Oncology and therapy2024 Jun
原文标识
PubMed 38512599 · DOI 10.1007/s40487-024-00269-4