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:Immune checkpoint inhibitors targeting PD-1/PD-L1 in the treatment of human lymphomas.
Immune checkpoint inhibitors targeting PD-1/PD-L1 in the treatment of human lymphomas.
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非霍奇金淋巴瘤(NHL)包括一组来源于不同分化阶段的B细胞、T细胞和自然杀伤(NK)细胞的多种恶性肿瘤。相反,经典霍奇金淋巴瘤(cHL)主要以里德-斯特恩伯格细胞(RSC)为特征,背景为反应性免疫细胞。免疫调节通路,尤其是PD-1/PD-L1轴,在NHL和cHL的肿瘤免疫逃逸中发挥关键作用。在一系列淋巴瘤中观察到PD-1和PD-L1表达升高,影响预后和治疗反应。在治疗方面,靶向PD-1/PD-L1的免疫检查点抑制剂(ICI)已彻底改变了淋巴瘤的管理,尤其是在复发/难治性病例中。Nivolumab和pembrolizumab等药物已在多种B细胞淋巴瘤中显示出疗效,在cHL中也有令人鼓舞的结果。将ICI与常规化疗或靶向药物联合的组合策略显示出增强的疗效,并正在被广泛探索。在这篇综述中,我们讨论NHL和cHL肿瘤微环境的最重要特征,探讨ICI的治疗方法,并尝试勾勒未来前景。
Non-Hodgkin lymphomas (NHLs) encompass a diverse group of malignancies arising from B cells, T cells, and natural killer (NK) cells at various stages of differentiation. Conversely, classical Hodgkin lymphomas (cHLs) primarily feature Reed-Sternberg cells (RSCs) amid a background of reactive immune cells. Immunomodulatory pathways, notably the PD-1/PD-L1 axis, play pivotal roles in tumor immune evasion across both NHLs and cHLs. Elevated expression of PD-1 and PD-L1 is observed in a spectrum of lymphomas, influencing prognosis and treatment response.
Therapeutically, immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 have revolutionized lymphoma management, particularly in relapsed/refractory cases. Nivolumab and pembrolizumab, among others, have demonstrated efficacy in various B-cell lymphomas, with promising outcomes in cHL.
Combination strategies incorporating ICIs with conventional chemotherapy or targeted agents show enhanced efficacy and are being explored extensively. In this review we discuss the most important features of the tumor microenvironment of NHLs and cHLs, address the therapeutic approaches with ICIs and try to outline future perspectives.
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