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:Management of Adverse Reactions to Loncastuximab in Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma.
Management of Adverse Reactions to Loncastuximab in Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma.
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弥漫性大B细胞淋巴瘤(DLBCL)是全球最常见的B细胞非霍奇金淋巴瘤。复发DLBCL的三线及以后治疗选择包括CAR-T 细胞疗法、T细胞衔接双特异性抗体和loncastuximab tesirine(loncastuximab tesirine-lpyl [Lonca]),每种治疗各有其独特的毒性特征。目前仍缺乏关于管理Lonca相关不良事件(AE)的指导,尤其是对于对这种抗体-药物偶联物经验有限的肿瘤科医生而言。
在此,2024年6月至8月期间对美国淋巴瘤专家进行了一项在线调查,评估了实践模式和经验,包括Lonca治疗模式、AE管理、患者关切和医生认知。基于这些回答,开发了一套算法以帮助管理Lonca相关AE。最常报告的AE为水肿和皮疹/光敏反应,通常发生在前4次给药期间,而疲劳是最常见的患者关切。Lonca相关AE的管理方式包括延迟或停用Lonca,或根据所观察到的AE处方利尿剂、类固醇或抗组胺药。调查结果与既往临床试验的发现一致,支持Lonca相关AE在多种临床环境中具有可管理性。所纳入的算法为管理AE(如水肿、骨髓抑制和皮肤反应)提供了指导。
Diffuse large B-cell lymphoma (DLBCL) is the most common B-cell non-Hodgkin lymphoma in the world. Treatment options for relapsed DLBCL in the third line and beyond include chimeric antigen receptor T-cell therapy, T-cell-engaging bispecific antibodies, and loncastuximab tesirine (loncastuximab tesirine-lpyl [Lonca]), each with unique toxicity profiles. There is still an unmet need for guidance on managing Lonca-associated adverse events (AEs), particularly for oncologists who have limited experience with this antibody-drug conjugate.
Here, an online survey among lymphoma specialists in the US between June and August 2024 assessed practice patterns and experiences, including Lonca treatment patterns, AE management, patient concerns, and physician perceptions. Based on these responses, an algorithm was developed to help manage Lonca-associated AEs. The most commonly reported AEs were edema and rash/photosensitivity, typically occurring within the first 4 doses, whereas fatigue was the most common patient concern.
Lonca-associated AEs were managed by delaying or discontinuing Lonca or by prescribing diuretics, steroids, or antihistamines, depending on the AE observed. The survey results align with findings from prior clinical trials and support the manageability of Lonca-associated AEs in a wide variety of settings. The included algorithm provides guidance for managing AEs, such as edema, myelosuppression, and cutaneous reactions.
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