决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Treatment of relapsed and refractory follicular lymphoma: which treatment for which patient for which line of therapy?
近期进展已改变复发和难治性滤泡性淋巴瘤的治疗格局。
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。
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.
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