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:Charting the Course: Sequencing Immunotherapy for Multiple Myeloma.
Charting the Course: Sequencing Immunotherapy for Multiple Myeloma.
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多种嵌合抗原受体(CAR)T 细胞和双特异性抗体(bsAb)疗法已获批,用于复发/难治性多发性骨髓瘤(MM),并显示出令人瞩目的临床疗效。目前这两类治疗在复发/难治性疾病领域存在重叠适应证,凸显了优化选择和序贯顺序以最大化临床疗效的重要性。对于既往未接受 T 细胞靶向疗法的患者,在两种方案均可选择时应权衡多个因素,包括 CAR-T 细胞疗法的可及性和物流挑战、疾病特异性因素(如疾病复发速度)、患者特异性因素(如衰弱程度),以及各药物不同的毒性谱。无论先接受 CAR-T 细胞疗法再用 bsAb,还是顺序相反,序贯治疗均已显示临床疗效。安排这些药物的治疗顺序时,必须考虑多种影响治疗耐药的因素,并谨慎选择后续治疗,以获得良好的长期结局。
Multiple chimeric antigen receptor (CAR) T-cell and bispecific antibody (bsAb) therapies have been approved, demonstrating impressive clinical efficacy in relapsed/refractory multiple myeloma (MM). Currently, these treatment share overlapping approval indications in the relapsed/refractory space, highlighting the importance of optimal selection and sequencing to maximize clinical efficacy. For patients previously unexposed to T-cell-directed therapies, several factors should be weighed when both options are available.
These factors include access and logistical challenges associated with CAR T-cell therapy, disease-specific factors such as tempo of disease relapse, in addition to patient-specific factors such as frailty, and distinct toxicity profiles across these agents.
Sequential therapy, whether it involves CAR T-cell therapy followed by bsAb or vice versa, has demonstrated clinical efficacy. When sequencing these agents, it is crucial to consider various factors that contribute to treatment resistance with careful selection of treatments for subsequent therapy in order to achieve favorable long-term patient outcomes.
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