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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:CAR-T cell therapy in the treatment of relapsed or refractory primary central nervous system lymphoma: recent advances and challenges.
CAR-T cell therapy in the treatment of relapsed or refractory primary central nervous system lymphoma: recent advances and challenges.
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原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见且侵袭性强的淋巴瘤,局限于中枢神经系统(CNS)或玻璃体视网膜腔。以大剂量甲氨蝶呤(HD-MTX)为基础的免疫化疗是其一线治疗方案,早期缓解率高。然而,复发/难治性(R/R)患者在临床治疗中面临诸多困难和挑战。嵌合抗原受体(CAR)-T细胞为血液系统恶性肿瘤的治疗提供了一种有前景的选择,尤其是在R/R B细胞淋巴瘤和多发性骨髓瘤中。尽管由于PCNSL具有特定的肿瘤微环境(TME),大多数PCNSL病例被排除在关键性CAR-T 细胞临床试验之外,但现有的小样本临床前和临床研究表明,其总体安全性可接受,且抗肿瘤效果显著。在本综述中,我们将介绍CAR-T 细胞的发展历程,并总结CAR-T 细胞疗法在R/R PCNSL患者中的研究进展、局限性和未来展望。
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive lymphoma that is isolated in the central nervous system (CNS) or vitreoretinal space. High-dose methotrexate (HD-MTX)-based immunochemotherapy is the frontline for its treatment, with a high early response rate.
However, relapsed or refractory (R/R) patients present numerous difficulties and challenges in clinical treatment. Chimeric antigen receptor (CAR)-T cells offer a promising option for the treatment of hematologic malignancies, especially in the R/R B-cell lymphoma and multiple myeloma.
Despite the exclusion of most PCNSL cases from pivotal CAR-T cell trials due to their specific tumor microenvironment (TME), available preclinical and clinical studies with small cohorts suggest an overall acceptable safety profile and remarkable anti-tumor effects. In this review, we will provide the development process of CAR-T cells and summarize the research progress, limitations, and future perspectives of CAR-T cell therapy in patients with R/R PCNSL.
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