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:Chimeric antigen receptor T-cell therapy and bispecific antibodies in the treatment of lymphoma for human immunodeficiency virus-infected patients: A systematic review.
Chimeric antigen receptor T-cell therapy and bispecific antibodies in the treatment of lymphoma for human immunodeficiency virus-infected patients: A systematic review.
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早期研究结果支持 CAR-T 细胞疗法在人类免疫缺陷病毒相关淋巴瘤中的可行性和潜在疗效。
CAR-T 细胞疗法(CAR-T)已成为复发/难治性(R/R)弥漫大B细胞淋巴瘤(DLBCL)的新治疗模式,患者有望治愈。然而,由于非临床障碍和对入组资格的误解,部分患者可能无法接受CAR-T 治疗,反而被错误分配至治疗路径,导致成本和结局不理想。本研究旨在量化巴西R/R DLBCL患者可用治疗序列中此类错误分配带来的经济影响。
回顾并综合目前关于CAR-T 细胞疗法和双特异性抗体治疗人类免疫缺陷病毒(HIV)相关淋巴瘤的文献,考察疗效、安全性和潜在实施障碍。
使用PubMed开展系统文献综述。纳入2000年1月至2024年9月发表的临床试验、队列研究、病例报告和临床前研究。检索词包括“HIV”“淋巴瘤”“CAR-T 细胞疗法”“双特异性抗体”“免疫疗法”和“HIV相关淋巴瘤”。
初步数据提示,HIV感染者接受CAR-T 细胞疗法是可行的,其缓解率与HIV阴性人群相当,不良事件(包括CRS和神经毒性)可管理。工程化改造CAR-T 细胞以靶向HIV感染细胞,正作为潜在治愈策略接受研究。但免疫抑制、抗原表达低及与抗逆转录病毒治疗的相互作用等挑战增加了治疗复杂性。双特异性抗体治疗血液系统恶性肿瘤显示出潜力,但由于试验排除了HIV感染者,该人群相关数据仍有限。
早期发现支持CAR-T 细胞疗法治疗HIV相关淋巴瘤的可行性和潜在疗效。需要更大规模的对照试验以确定安全性、优化治疗策略并扩大HIV感染者的治疗选择。
Chimeric antigen receptor T-cell therapy has emerged as a highly effective treatment for relapsed and refractory lymphomas; however, its application in individuals with human immunodeficiency virus remains underexplored. People with human immunodeficiency virus face an increased risk of developing malignancies such as lymphoma, where standard chemotherapy often results in suboptimal responses and heightened toxicity.
To review and synthesize current literature on the use of chimeric antigen receptor T-cell therapy and bispecific antibodies in human immunodeficiency virus-associated lymphoma, examining efficacy, safety, and potential barriers to implementation.
A systematic review of the literature was conducted using PubMed. Included studies comprised clinical trials, cohort studies, case reports, and preclinical research published between January 2000 and September 2024. Search terms included "HIV," "lymphoma," "CAR T cell therapy," "bispecific antibodies," "immunotherapy," and "HIV-associated lymphoma."
Preliminary data suggest chimeric antigen receptor T-cell therapy is feasible in human immunodeficiency virus-positive patients, with response rates comparable to human immunodeficiency virus-negative populations and manageable adverse events, including cytokine release syndrome and neurotoxicity. Engineering chimeric antigen receptor T cells to target human immunodeficiency virus-infected cells is under investigation as a potential curative strategy. However, challenges such as immunosuppression, low antigen expression, and interactions with antiretroviral therapy complicate treatment. Bispecific antibodies have shown promise in hematologic malignancies, but data in people with human immunodeficiency virus remain limited due to trial exclusions.
Early findings support the feasibility and potential efficacy of chimeric antigen receptor T-cell therapy in human immunodeficiency virus-associated lymphoma. Larger, controlled trials are needed to establish safety, optimize treatment strategies, and expand therapeutic options for people with human immunodeficiency virus.
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