决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
英文原题:CAR-T cell therapy in relapsed or refractory multiple myeloma and access in Turkey.
CAR-T cell therapy in relapsed or refractory multiple myeloma and access in Turkey.
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过去十年见证了多发性骨髓瘤(MM)免疫治疗的发展,从复发/难治性 setting 中的单克隆抗体(mAbs)开始,最终达到CAR-T 细胞和双特异性抗体(BsAbs)的市场批准。医学界正在评估这些靶向免疫疗法的疗效和安全性,其中大多数目前靶向浆细胞表面的 B 细胞成熟抗原(BCMA)。有两种抗 BCMA CAR-T 产品可用于治疗复发/难治性 MM:idecabtagene vicleucel(ide-cel)和 ciltacabtagene autoleucel(cilta-cel)。Ide-cel 和 cilta-cel 显示出在重度预处理疾病中诱导深度缓解的能力,包括三重难治性和五重难治性疾病的患者。
然而,这些药物之间存在关键的相似性和差异,其比较疗效和毒性的未知因素,以及对这些新免疫疗法耐药性的机制。本综述讨论了复发难治性 MM 中的 CAR-T 细胞疗法,重点关注疗效、毒性以及这些疗法在美国的演变轨迹,以及在土耳其的可及性。
The past decade has seen the development of immunotherapy for the treatment of multiple myeloma (MM), beginning with monoclonal antibodies (mAbs) in the relapsed and refractory setting and culminating in the market approval of chimeric antigen receptor T cells (CAR-T) and bispecific antibodies (BsAbs). The medical community is evaluating the efficacy and safety of these targeted immunotherapies, most of which currently target B-cell maturation antigen (BCMA) on the surface of plasma cells.
Two anti-BCMA CAR-T products are available for treating relapsed or refractory MM: idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel). Ide-cel and cilta-cel demonstrate the ability to induce deep responses in heavily pretreated diseases, including patients with triple-class-refractory and penta-refractory diseases.
However, there are key similarities and differences regarding these agents, unknowns regarding their comparative efficacy and toxicity, and mechanisms underlying resistance to these new immunotherapies. This review discusses CAR-T cell therapy in relapsed refractory MM, with a focus on efficacy, toxicities, and the evolving trajectories of these therapies in the USA, as well as access in Turkey.
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