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:Targeted and epigenetic therapies for acute myeloid leukemia treatment.
本文全面概述了急性髓系白血病(AML)的靶向治疗和表观遗传治疗,强调其在推进治疗策略中的作用。
本文全面综述急性髓系白血病(AML)的靶向治疗和表观遗传治疗,重点介绍其在推动治疗策略发展中的作用。AML源于复杂的遗传及表观遗传改变;对其发病机制认识的深入,为精准医疗奠定了基础。文章回顾了关键靶向疗法,包括用于IDH突变的IDH抑制剂(如艾伏尼布、恩西地平)、用于FLT3改变的FLT3抑制剂(如米哚妥林、吉瑞替尼)、影响细胞凋亡的BCL2抑制剂(如维奈克拉),以及针对KMT2A重排或NPM1突变等特定亚型的新兴Menin抑制剂。文章还讨论靶向可逆性改变的表观遗传治疗,例如作用于DNA甲基化的DNMT抑制剂(如阿扎胞苷、地西他滨)、作用于组蛋白修饰的HDAC抑制剂,以及其他正在研发、靶向表观遗传调控因子的有前景药物。此外,文章探讨基因治疗这一重要未来方向,介绍CRISPR/Cas9基因编辑进展,以及保护健康造血细胞免受靶向毒性(如编辑CD33、CD123)或增强免疫细胞抗白血病功能(如CAR-T、TCR疗法)的策略。未来展望强调,应开发协同联合疗法,并利用分子层面的认识真正实现个体化治疗,以克服治疗挑战并改善AML患者的长期结局。
This article provides a comprehensive overview of targeted and epigenetic therapies for acute myeloid leukemia (AML), highlighting their role in advancing treatment strategies. Recognizing that AML arises from complex genetic and epigenetic alterations, a deeper understanding of its pathogenesis has paved the way for precision medicine. The article reviews key targeted therapies, including IDH inhibitors (e.g., ivosidenib, enasidenib) for IDH mutations, FLT3 inhibitors (e.g., midostaurin, gilteritinib) for FLT3 alterations, BCL2 inhibitors (e.g., venetoclax) impacting apoptosis, and emerging Menin inhibitors for specific subtypes like KMT2A-rearranged or NPM1-mutant AML. It also discusses epigenetic therapies that target reversible changes, such as DNMT inhibitors (e.g., azacitidine, decitabine) for DNA methylation and HDAC inhibitors for histone modifications, along with other promising agents under development targeting epigenetic regulators. Furthermore, the article explores gene therapy as a significant future direction, detailing advancements in gene editing (CRISPR/Cas9) and strategies designed to shield healthy hematopoietic cells from targeted toxicity (e.g., CD33, CD123 editing) or to enhance the anti-leukemic function of immune cells (e.g., CAR-T, TCR therapy). The future perspective emphasizes the importance of developing synergistic combination therapies and leveraging molecular insights for truly personalized treatment approaches to overcome therapeutic challenges and improve long-term outcomes for AML patients.
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