肿瘤细胞治疗研究
英文原题:Chimeric antigen receptor T-cell therapy for haematological malignancies: Insights from fundamental and translational research to bedside practice.
Chimeric antigen receptor T-cell therapy for haematological malignancies: Insights from fundamental and translational research to bedside practice.
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自体嵌合抗原受体(CAR)T细胞疗法已经彻底改变了淋巴系统恶性肿瘤的治疗,促使CD19-CAR-T 细胞获批用于B细胞淋巴瘤和急性白血病,以及最近BCMA-CAR-T 细胞获批用于多发性骨髓瘤。早期临床试验中接受治疗患者的长期随访显示了长期缓解的可能性,提示可能治愈。这与显著长期副作用发生率低以及缓解者生活质量快速改善相关。相比之下,其他类型的免疫疗法需要长期治疗,或存在损害生活质量的长期副作用风险。尽管结果令人瞩目,一些患者仍会出现治疗失败或最终复发,这凸显了改进CAR-T 细胞疗法并更好地理解其疗效决定因素以最大化积极结局的必要性。虽然下一代CAR-T 细胞无疑将更加强效,但在使用当前可用的CAR-T 细胞时,已经存在优化的机会。这篇综述文章旨在总结来自临床、转化和基础研究的当前证据,为临床医生提供见解,以增强他们对CAR-T 细胞的理解和使用。
Autologous chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of lymphoid malignancies, leading to the approval of CD19-CAR T cells for B-cell lymphomas and acute leukaemia, and more recently, B-cell maturation antigen-CAR T cells for multiple myeloma. The long-term follow-up of patients treated in the early clinical trials demonstrates the possibility for long-term remission, suggesting a cure. This is associated with a low incidence of significant long-term side effects and a rapid improvement in the quality of life for responders. In contrast, other types of immunotherapies require prolonged treatments or carry the risk of long-term side effects impairing the quality of life.
Despite impressive results, some patients still experience treatment failure or ultimately relapse, underscoring the imperative to improve CAR T-cell therapies and gain a better understanding of their determinants of efficacy to maximize positive outcomes.
While the next-generation of CAR T cells will undoubtingly be more potent, there are already opportunities for optimization when utilizing the currently available CAR T cells. This review article aims to summarize the current evidence from clinical, translational and fundamental research, providing clinicians with insights to enhance their understanding and use of CAR T cells.
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