← 返回前沿论文

复发性及难治性滤泡性淋巴瘤的治疗:哪种治疗用于哪类患者、哪线治疗?

英文原题:Treatment of relapsed and refractory follicular lymphoma: which treatment for which patient for which line of therapy?

PubMed 2025/10/09(内容时间) Blood Q1 · IF 23.9(JCR 2025)

研究概要

近期进展已改变复发和难治性滤泡性淋巴瘤的治疗格局。

中文摘要

近期进展已改变复发和难治性滤泡性淋巴瘤的治疗格局。尽管化疗长期以来一直是治疗的基石,但新型靶向、免疫调节和免疫治疗方法的出现正在挑战其相关性。这些方法聚焦于靶向表观遗传调控因子、B细胞受体或其下游细胞内通路的组分以及滤泡性淋巴瘤肿瘤微环境。近期双特异性抗体和CAR-T 细胞疗法的发展,可同时靶向肿瘤相关抗原和宿主特异性抗原,使免疫系统得以重定向,增强固有抗肿瘤免疫应答。这些策略的合理联合正在复发和难治性 setting 中积极评估,并将不可避免地推进至更早线的治疗。这些方法的成功为患者和临床医生带来了众多并行的选择。当前新出现的挑战在于如何最好地针对每位复发或难治性滤泡性淋巴瘤患者进行个体化处理,应对复杂的决策过程,需考虑患者既往治疗史、治疗目标、复发的临床和生物学特征以及个人偏好。理解难治性和转化性疾病的影响,以及复发的时机和生物学特征,对于在现代支持更个性化的治疗方法将至关重要。

展开英文摘要原文

Recent advances have transformed the treatment landscape for relapsed and refractory follicular lymphoma. Although chemotherapy has long served as the backbone of treatment, the availability of novel targeted, immunomodulatory, and immunotherapeutic approaches is challenging its relevance. These approaches have focused on targeting epigenetic regulators, components of the B-cell receptor or its downstream intracellular pathways and the follicular lymphoma tumor microenvironment. The recent development of bispecific antibodies and chimeric antigen receptor T-cell therapies, which target both tumor-associated and host-specific antigens, has enabled a redirection of the immune system, enhancing the innate antitumor immune response. Rational combinations of these strategies are actively being evaluated in the relapsed and refractory setting and will inevitably move forward into earlier lines of treatment. The success of these approaches has led to numerous and parallel options for patients and clinicians. The emerging challenge now lies in how best to approach each individual patient with relapsed or refractory follicular lymphoma, addressing complex decision-making that considers a patient's previous treatment history, goals of care, clinical and biological characteristics of recurrence, and personal preferences. Understanding the implications of refractory and transformed disease, as well as the timing and biology of relapse will be critical to support a more personalized treatment approach in the modern era.

论文信息

作者
Casulo C、Sehn LH
第一作者单位
Department of Medicine, Wilmot Cancer Institute, University of Rochester, Rochester, NY.United States
通讯作者单位
Division of Medical Oncology, BC Cancer Centre for Lymphoid Cancer and The University of British Columbia, Vancouver, Canada.Canada
文献类型
综述
期刊
Blood2025 Oct 9
原文标识
PubMed 40811857 · DOI 10.1182/blood.2024026018