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成人急性淋巴细胞白血病中不断演变的治疗革命

英文原题:The evolving therapeutic revolution in adult acute lymphoblastic leukemia.

查看英文原题

The evolving therapeutic revolution in adult acute lymphoblastic leukemia.

PubMed 2025/05/15(内容时间) Cancer Q1 · IF 5.6(JCR 2025)

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中文摘要

过去十年间,急性淋巴细胞白血病(ALL)病理生理机制的解析及新型靶向治疗的开发取得显著进展。基础研究和基因组图谱分析发现了新的预后生物标志物、治疗靶点和ALL亚型(如费城染色体样ALL)。目前ALL治疗领域的变革,得益于将靶向ABL融合基因的疗法(如BCR::ABL1酪氨酸激酶抑制剂)以及靶向CD19和CD22的新型药物纳入治疗方案,包括CD22抗体药物偶联物奥加伊妥珠单抗、CD3/CD19双特异性T细胞衔接抗体贝林妥欧单抗,以及靶向CD19的CAR-T 细胞疗法。这些治疗组合使B细胞ALL的长期生存率提高至70%,费城染色体阳性ALL提高至80%–90%。治疗目标是实现与儿童ALL相当的治愈率,并减少或免除长期强化/维持化疗及其相关毒性。

展开英文摘要原文

The past decade has witnessed remarkable advances in deciphering the pathophysiology of acute lymphoblastic leukemia (ALL) and in developing novel targeted therapies. Basic research and genomic mapping have identified new prognostic biomarkers, targets, and ALL subtypes (e. g. , Philadelphia-like ALL). The ongoing therapeutic revolution in ALL is driven by the addition to the treatment arsenal of therapies that target the ABL fusions, like the BCR::ABL1 tyrosine kinase inhibitors, as well as novel agents that target CD19 and CD22: the CD22 antibody-drug conjugate inotuzumab ozogamicin, the bispecific CD3/CD19 T-cell engager antibody blinatumomab, and CD19 chimeric antigen receptor T-cell therapies.

These combinations have improved the long-term survival rates in B-cell ALL to 70%, and in Philadelphia chromosome-positive ALL to 80%-90%. The desired goals are to achieve cure rates comparable to those in pediatric ALL and to reduce or eliminate the need for prolonged intensive/maintenance chemotherapy and associated toxicities.

论文信息

作者
Kantarjian H、Jain N、Litzow MR、Luger SM、Papayannidis C、Ribera JM、Short NJ、Chifotides HT
单位
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.United States
文献类型
综述
期刊
Cancer2025 May 15
原文标识
PubMed 40323723 · DOI 10.1002/cncr.35872