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:T-Cell Redirecting Strategies in Large B-Cell Lymphoma and Follicular Lymphoma.
T-Cell Redirecting Strategies in Large B-Cell Lymphoma and Follicular Lymphoma.
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嵌合抗原受体(CAR)T细胞疗法的出现彻底改变了复发/难治性大B细胞淋巴瘤(LBCL)的治疗格局。在获得三线(3L+)监管批准后,随机试验证实,对于一线治疗后12个月内出现疾病进展的患者,该疗法优于标准治疗的挽救性化学免疫治疗(CIT)和自体干细胞移植。另一方面,双特异性抗体(BsAbs)已获批用于3L+,而试验正在探索其在更早期治疗中的潜力,通常与CIT联合使用。在滤泡性淋巴瘤(FL)中,两种T细胞重定向策略均已获批用于3L+。与即用型BsAbs相比,CAR-T 细胞在FL中更高的缓解率伴随着毒性风险增加和物流障碍。本综述聚焦于CAR-T 细胞和BsAbs在LBCL和FL中的作用,特别关注现有结果和序贯治疗方法。
The advent of chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment landscape of relapsed/refractory large B-cell lymphoma (LBCL). After achieving regulatory approval in third line (3L+), randomized trials confirmed superiority over standard-of-care salvage chemoimmunotherapy (CIT) and autologous stem-cell transplantation in patients experiencing progressive disease within 12 months of first-line treatment.
On the other hand, bispecific antibodies (BsAbs) are approved in the 3L+, while trials are exploring their potential in an earlier setting, usually in combination with CIT. In follicular lymphoma (FL), both T-cell redirecting strategies are approved in 3L+.
The higher response rate with CAR T cells in FL comes at the cost of an increased toxicity risk and logistical barriers, in comparison with off-the-shelf BsAbs. This review focuses on the role of CAR T cells and BsAbs in LBCL and FL, paying special attention to available results and sequencing approaches.
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