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:Talquetamab in Multiple Myeloma: Efficacy, Safety, and Future Directions.
Talquetamab in Multiple Myeloma: Efficacy, Safety, and Future Directions.
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尽管免疫疗法不断进步,复发/难治性多发性骨髓瘤(RRMM)仍是具有挑战性的疾病。包括塔奎妥单抗在内的新型双特异性抗体(BsAb),在既往接受多线治疗的患者中显示出良好疗效,即便是对三类或五类药物耐药的患者亦如此。塔奎妥单抗近期获得美国FDA和欧洲药品管理局(EMA)批准,适用于既往至少接受三或四线治疗(LOT)后疾病进展的患者。通过阶梯式递增给药控制细胞因子释放综合征(CRS)后,塔奎妥单抗的总体缓解率(ORR)约为70%,包括既往接受T细胞重定向治疗的患者。其安全性特征与其他BsAb一致,常见血液学不良事件包括贫血和中性粒细胞减少,同时存在独特的靶向肿瘤外毒性,如味觉障碍和皮肤相关事件。感染发生率较其他BsAb低。塔奎妥单抗与其他治疗(包括CAR-T 细胞疗法)的最佳排序仍在积极研究中,因为抗BCMA疗法耐药仍是持续的临床挑战。目前的试验正在探索塔奎妥单抗联合治疗,以及疾病进展后的治疗策略。真实世界数据进一步支持塔奎妥单抗的疗效,使其成为RRMM治疗的重要选择。
Relapsed and refractory multiple myeloma (RRMM) remains a challenging condition despite advances in immunotherapies. Novel bispecific antibodies (BsAbs), including talquetamab, have shown promising efficacy in heavily pretreated patients, even those with triple- and penta-refractory disease. Talquetamab, recently approved by the FDA and EMA, is indicated for patients who have progressed after at least three or four prior lines of therapy (LOTs). Administered following a step-up dosing phase to manage cytokine release syndrome (CRS), talquetamab demonstrated a high overall response rate (ORR) of approximately 70%, including in patients previously treated with T-cell redirecting therapies.
Its safety profile is consistent with other BsAbs, with hematologic adverse events such as anemia and neutropenia commonly reported, alongside unique on-target off-tumor toxicities like dysgeusia and skin-related events. Infections were less frequent compared to other BsAbs.
The optimal sequencing of talquetamab and other therapies, including CAR-T cell treatments, remains an area of active research, as resistance to anti-BCMA therapies presents ongoing clinical challenges. Current trials are exploring the use of talquetamab in combination therapies, as well as therapeutic strategies post-treating progression. The real-world data further support talquetamab's efficacy, making it a valuable addition to the RRMM treatment landscape.
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