不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Novel Targets and Advanced Therapies in Diffuse Large B Cell Lymphomas.
Novel Targets and Advanced Therapies in Diffuse Large B Cell Lymphomas.
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自20世纪90年代末利妥昔单抗问世以来,B细胞淋巴瘤的靶向治疗取得了显著进展,提高了患者的治愈机会,也丰富了临床医生的治疗手段。对疾病生物学和致病通路的更深入理解,加上免疫表型和分子诊断技术的改进,在这些成就中发挥了关键作用。尽管传统化疗在大多数病例中仍是基础治疗,但围绕化疗耐药性和累积毒性的担忧,特别是造血储备的耗竭,凸显了个性化治疗方法的必要性。将靶向药物,尤其是单克隆抗体,与化疗相结合,已带来更高的缓解率和更长的生存期。随着创新性靶向治疗取代细胞毒性药物,一场显著的范式转变正在进行,挑战了干细胞移植等传统挽救策略。本综述审视了淋巴瘤细胞新兴靶点的全景,并探讨了弥漫性大B细胞淋巴瘤(DLBCL)的创新疗法。从CAR-T 细胞到更强效的单克隆抗体、抗体药物偶联物、双特异性抗体、检查点抑制剂以及靶向细胞内通路的小分子药物,每种治疗模式都为治疗进展提供了有前景的途径。本综述旨在提供关于这些疗法对DLBCL未来治疗策略潜在影响的见解。
Since the introduction of rituximab in the late 1990s, significant progress has been made in advancing targeted therapies for B cell lymphomas, improving patients' chance of being cured and clinicians' therapeutic armamentarium. A better understanding of disease biology and pathogenic pathways, coupled with refinements in immunophenotypic and molecular diagnostics, have been instrumental in these achievements. While traditional chemotherapy remains fundamental in most cases, concerns surrounding chemorefractoriness and cumulative toxicities, particularly the depletion of the hemopoietic reserve, underscore the imperative for personalized treatment approaches. Integrating targeted agents, notably monoclonal antibodies, alongside chemotherapy has yielded heightened response rates and prolonged survival.
A notable paradigm shift is underway with innovative-targeted therapies replacing cytotoxic drugs, challenging conventional salvage strategies like stem cell transplantation. This review examines the landscape of emerging targets for lymphoma cells and explores innovative therapies for diffuse large B cell lymphoma (DLBCL).
From Chimeric Antigen Receptor-T cells to more potent monoclonal antibodies, antibody-drug conjugates, bispecific antibodies, checkpoint inhibitors, and small molecules targeting intracellular pathways, each modality offers promising avenues for therapeutic advancement. This review aims to furnish insights into their potential implications for the future of DLBCL treatment strategies.
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