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:BV and beyond: how to incorporate novel agents into PTCL management.
BV and beyond: how to incorporate novel agents into PTCL management.
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外周T细胞淋巴瘤(PTCL)是一组具有异质性但侵袭性强的淋巴瘤,来源于成熟T细胞或NK细胞前体。结内PTCL包括间变性大细胞淋巴瘤、非特指型PTCL和滤泡辅助性T细胞淋巴瘤。对这些异质性疾病认识的近期进展促使研究者探索新药以改进治疗。基于ECHELON-2试验,CD30抗体药物偶联物brentuximab vedotin已纳入CD30表达型PTCL的一线治疗方案。多项正在进行的试验正评估一线及复发/难治性场景中加入其他靶向药物的疗效,包括单药brentuximab vedotin、组蛋白去乙酰化酶抑制剂、duvelisib、ruxolitinib、EZH2抑制剂和azacitidine等。鉴于滤泡辅助性T细胞淋巴瘤常见表观遗传调控基因突变,患者可能优先从组蛋白去乙酰化酶抑制剂、EZH2抑制剂和低甲基化药物等药物中获益。随着这些疗法从复发/难治性疾病逐步拓展到一线治疗,亚型特异性疗法可能有助于实现PTCL患者治疗个体化。
Peripheral T-cell lymphomas (PTCLs) are a heterogenous yet aggressive group of lymphomas that arise from mature T- or NK-cell precursors. Nodal PTCLs include anaplastic large-cell lymphoma, PTCL not otherwise specified, and follicular helper T-cell lymphomas. Recent advances in understanding these heterogenous diseases have prompted investigation of novel agents to improve on treatment. Brentuximab vedotin, a CD30 antibody-drug conjugate, has been incorporated into frontline treatment regimens of CD30-expressing PTCLs based on the ECHELON-2 trial. Multiple ongoing trials are evaluating the addition of other targeted agents in the frontline and relapsed/refractory setting.
These include single-agent brentuximab vedotin, histone deacetylase inhibitors, duvelisib, ruxolitinib, EZH2 inhibitors, and azacitidine, among others. Follicular helper T-cell lymphomas, given frequent mutations in epigenetic regulator genes, may preferentially respond to agents such as histone deacetylase inhibitors, EZH2 inhibitors, and hypomethylating agents. As these therapies evolve in their use for both relapsed/refractory disease and then into frontline treatment, subtype-specific therapy will likely help personalize care for patients with PTCL.
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