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:Mobilizing CARs: Benefits, drawbacks, and directions for outpatient CAR T-cell therapy.
Mobilizing CARs: Benefits, drawbacks, and directions for outpatient CAR T-cell therapy.
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CAR-T 细胞疗法开启了多种血液系统恶性肿瘤治疗的新时代,并且越来越多地被用于更早期的治疗线数。此外,细胞疗法目前正在研究其在治疗实体恶性肿瘤和自身免疫性疾病方面的潜力。随着 CAR-T 疗法适应症范围不断扩大,同时相关成本和住院需求下降,许多医疗中心正逐步转向门诊 CAR-T 模式。
此外,为减轻细胞因子释放综合征(CRS)或神经毒性等并发症,正在进行包括开发预用药策略、及时管理不良事件以及推进更新、更安全的 CAR-T 细胞疗法等工作。
然而,尽管取得了这些进展,这些危及生命的并发症的固有风险仍然是 CAR-T 疗法中的一个关键问题。医疗机构必须积极预判并有效管理这些并发症,以确保接受 CAR-T 疗法患者的安全与健康。这包括建立可靠的方案,以及时识别和干预不良事件,并在必要时为患者转入更高层级护理提供顺畅路径。本综述概述了当前门诊 CAR-T 疗法的现状,并就实施成功的门诊 CAR-T 项目所需的关键临床和运营考量提供了重要见解。
Chimeric antigen receptor T-cell (CAR-T) therapy has heralded a new era in the treatment of various hematological malignancies, increasingly being utilized in earlier lines of therapy.
Moreover, cellular therapies are currently under investigation for their potential in treating solid malignancies and autoimmune disorders. As the scope of indications for CAR-T therapy continues to expand, along with the associated reductions in costs and hospital admissions, many medical centers are transitioning towards outpatient CAR-T models.
Moreover, ongoing efforts to mitigate complications such as cytokine release syndrome (CRS) or neurotoxicity include the development of premedication strategies, prompt management of adverse events, and the advancement of newer, safer CAR-T cell therapies.
However, despite these advancements, the inherent risk of these life-threatening complications remains a critical concern in CAR-T therapy. Institutions must diligently anticipate and effectively manage these complications to ensure the safety and well-being of patients undergoing CAR-T therapy.
This includes establishing robust protocols for timely identification and intervention of adverse events, and seamless pathways for transitioning patients to a higher level of care if necessary. This review provides an overview of the current landscape of outpatient CAR-T therapy and offers essential insights into the key clinical and operational considerations needed to implement a successful outpatient CAR-T program.
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