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:Novel CAR T cell therapies for patients with large B cell lymphoma.
Novel CAR T cell therapies for patients with large B cell lymphoma.
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约 60%–70% 的大 B 细胞淋巴瘤(LBCL)患者在初始治疗后可获得长期缓解或治愈。然而,初始治疗后复发或难治的患者预后较差。近期,嵌合抗原受体(CAR)T 细胞疗法因有望使复发或对常规化疗难治的 LBCL 患者获得治愈或长期缓解而备受关注。目前临床上可用于 LBCL 的 CAR-T 细胞产品有三种:tisagenlecleucel(tisa-cel)、axicabtagene ciloleucel(axi-cel)和 lisocabtagene maraleucel(liso-cel)。这些产品最初在全球获批作为三线或更后线治疗。近期,对于一线化疗后早期复发或难治的患者,axi-cel 和 liso-cel 已可作为二线治疗。尽管 CAR-T 细胞疗法已积累大量数据,如何在这三种可用产品之间进行选择这一临床问题仍未解决。CAR-T 治疗后复发患者的适当治疗选择也尚不明确。本综述讨论旨在最大化 CAR-T 细胞疗法获益的治疗策略。
Approximately 60-70% of patients with large B cell lymphoma (LBCL) achieve long-term remission or a cure after initial treatment.
However, patients who relapse or are refractory to initial treatment have a poor prognosis. Chimeric antigen receptor (CAR) T cell therapy has recently attracted attention for its potential to provide a cure or long-term remission even for LBCL that has relapsed or is refractory to conventional chemotherapy. Currently, three CAR T cell products are clinically available for LBCL: tisagenlecleucel (tisa-cel), axicabtagene ciloleucel (axi-cel) and lisocabtagene maraleucel (liso-cel). These CAR T cell products were initially approved as third- or later-line therapies worldwide.
Recently, axi-cel and liso-cel have become feasible as second-line therapies for patients with early relapsed or refractory disease after first-line chemotherapy. Although a large body of data on CAR T cell therapy has been accumulated, the clinical question of how to choose between these three available CAR T cell products has yet to be resolved.
The appropriate approach to treatment selection for patients who relapse after CAR T cell therapy also remains unclear. This review discusses treatment strategies to maximize the benefits of CAR T cell therapy.
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