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:Real-World Evidence of Relapsed/Refractory Mantle Cell Lymphoma Patients and Treatments: A Systematic Review.
Real-World Evidence of Relapsed/Refractory Mantle Cell Lymphoma Patients and Treatments: A Systematic Review.
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复发/难治性套细胞淋巴瘤在临床和生物学上具有异质性,仍是一项治疗挑战,高危和早期复发患者仍存在未满足的医疗需求。
引言:套细胞淋巴瘤(MCL)是一种无法治愈、临床过程侵袭性强的疾病,多数患者在化疗后最终复发。针对复发/难治性 MCL 开发的靶向疗法已依据临床试验数据获批,但真实世界数据稀少且分散。综述范围:本系统综述旨在收集、综合并描述真实世界中接受二线或后续治疗的复发/难治性 MCL 患者特征及治疗结局。专家观点:复发/难治性 MCL 在临床和生物学上均具有异质性,仍是治疗挑战;高危患者和早期复发患者仍存在未满足的医疗需求。本系统综述受限于现有数据质量,以及疾病异质性导致结局难以比较的问题,但结果提示共价 BTK 抑制剂应作为二线治疗;对 BTK 抑制剂治疗后复发患者,可随后使用 CAR-T 细胞。近期已开发无化疗方案,以及在复发和一线治疗中与成熟化疗免疫治疗骨架联合的疗法;一线治疗选择也在改进,旨在将靶向和细胞疗法前移至更早治疗线,包括老年及体能状况适宜的年轻患者的一线治疗。未来几年,许多新型靶向药物将发挥重要作用,并在确定其应用顺序和未筛选患者结局后纳入常规实践。
INTRODUCTION: Mantle cell lymphoma (MCL) is an incurable disease with an aggressive clinical course, and most patients eventually relapse after chemotherapy. Targeted therapies developed for relapsed/refractory MCL have been approved based on clinical trial data.
However, real-world setting data are scarce and scattered. AREAS COVERED: This systematic review aimed to collect, synthesize, and describe the characteristics and treatment outcomes of patients with relapsed/refractory MCL after receiving a second or subsequent line of therapy in the real-world setting. EXPERT OPINION: R/R MCL is clinically and biologically heterogeneous and still represents a therapeutic challenge, with high-risk and early relapsed patients remaining an unmet medical need. This systematic review is limited by the quality of the available data and the difficulty of comparing outcomes in R/R MCL due to the heterogeneity of the disease, but the results suggest that covalent BTKis should be positioned as second-line therapy, followed by CAR T-cells in BTK-i-relapsed patients.
Chemo-free and combination therapies with established chemoimmunotherapy backbones in the relapsed and front-line settings have been recently developed, and front-line options are being improved to move targeted and cellular therapies to earlier lines, including front-line therapy, in elderly and younger fit patients. In the upcoming years, many new targeted agents will play an important role and will be incorporated to the routine practice as their sequence, and outcomes in unselected patients are determined.
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