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:Anti-CD19 CAR T-cell therapy for primary and secondary CNS lymphomas.
Anti-CD19 CAR T-cell therapy for primary and secondary CNS lymphomas.
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中枢神经系统淋巴瘤(CNSL)是一组异质性肿瘤,通常侵袭性较强,其预后差异显著:原发性疾病患者预后较好,继发性淋巴瘤患者预后较差。目前治疗通常为强化化疗,随后采用自体干细胞移植或全脑放疗巩固。但疾病复发后尚无确立的标准治疗。近期,抗CD19嵌合抗原受体(CAR)T细胞疗法获批用于系统性B细胞淋巴瘤,改变了此前无法治愈患者的治疗格局。尽管由于安全性和疗效顾虑,该疗法最初在CNSL中的研究有限,但可能为这些患者带来新的治疗途径。本综述简要概述当前CNSL治疗策略及其主要局限,包括复发率和长期毒性,随后探讨CNSL最重要的研究和临床试验,重点关注抗CD19 CAR-T 细胞疗法的近期进展。该综合分析将为有效治疗CNSL的成功经验和挑战提供见解。
Central nervous system lymphomas (CNSL) are a heterogeneous group of generally aggressive tumors whose prognosis varies significantly, being more favorable in patients with primary disease and poorer in those with secondary lymphoma. Current treatments typically involve intensive chemotherapy followed by consolidation with autologous stem cell transplantation or whole-brain radiotherapy.
However, if the disease relapses, there is no established standard of care. The recent approval of anti-CD19 chimeric antigen receptor (CAR) T-cell therapy for systemic B-cell lymphomas has shifted the treatment landscape for previously incurable patients. Even though this therapy was initially underexplored in the setting of CNSL due to safety and efficacy concerns, it could offer a new therapeutic avenue for these patients.
In this review, we will provide a concise overview of the current treatment strategies for CNSL, highlighting their key limitations, including relapse rates and long-term toxicity. Following this, we will explore the most important studies and clinical trials on CNSL, focusing on recent advancements in anti-CD19 CAR T-cell therapy. This comprehensive analysis will offer insights into the successes and challenges of treating CNSL effectively.
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