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探索针对人 B 细胞淋巴瘤的 CD19 靶向免疫治疗策略

英文原题:Exploring CD19-targeted Immunotherapy Strategies for Human B-cell Lymphoma.

PubMed 2025/04/30(内容时间) Arch Razi Inst

研究概要

B 细胞淋巴瘤(BCL)包含约 40 种亚型,均由成熟 B 细胞的恶性转化引起。

中文摘要

B细胞淋巴瘤(BCL)包括约40种亚型,均由成熟B细胞恶性转化而来。BCL的管理因具体亚型和淋巴瘤分期而异。治疗选择丰富,包括化疗、免疫治疗、放疗、靶向治疗和干细胞移植。其中,靶向治疗有望提高治疗方案的安全性和疗效。靶向治疗涵盖针对多种疾病相关特定分子和通路的疗法,包括单克隆抗体、纳米抗体、CAR-T细胞疗法及双特异性T细胞接合分子(BiTE)。这些治疗药物通过不同机制靶向CD79b、CD20、CD30、CD52和CD19等多种分子及受体。CD19是一种I型免疫球蛋白超家族跨膜糖蛋白,可通过调节受体依赖和非依赖信号,设定B细胞内在信号阈值。传统治疗及其他靶点存在局限,因此CD19是淋巴瘤治疗的可行靶点。目前FDA已批准多种抗CD19 CAR-T细胞疗法,包括Axicabtagene Ciloleucel、Tisagenlecleucel和Lisocabtagene Maraleucel,以及抗CD19单克隆抗体(mAb),如loncastuximab tesirine和tafasitamab。这些药物在多项临床试验中显示疗效。作为首个采用BiTE技术生产并获FDA批准的抗体,blinatumomab在治疗B细胞急性淋巴细胞白血病(B-ALL)的临床试验中显示显著获益。单域抗体(sdAb)或纳米抗体是仅含重链抗体(HcAb)纳米级VHH片段的抗体,已与CAR-T细胞联合使用并取得良好结果。本综述旨在探讨CD19作为淋巴瘤治疗有前景靶点的潜力,同时讨论多种CD19靶向治疗选择及相关临床研究,并全面阐述每种方法的疗效、安全性和局限。

展开英文摘要原文

B-cell lymphomas (BCLs) encompass approximately 40 subtypes arising from the malignant transformation of mature B-cells. The management of BCLs varies according to the specific type and stage of lymphoma. A plethora of therapeutic options are available, encompassing chemotherapy, immunotherapy, radiation therapy, targeted therapy, and stem cell transplantation. Among these approaches, targeted therapy has demonstrated considerable promise in terms of its potential to enhance safety and efficacy in treatment regimens. The field of targeted therapies encompasses a range of treatments that are designed to target specific molecules and pathways involved in various diseases. These therapies include monoclonal antibodies, nanobodies, CAR-T cell therapies, and bispecific T-cell engager (BiTE) molecules. These therapeutic agents operate through various mechanisms, targeting a variety of molecules and receptors associated with different diseases, such as CD79b, CD20, CD30, CD52, and CD19. CD19 is an immunoglobulin superfamily transmembrane glycoprotein of type I, which is necessary for setting intrinsic B-cell signaling thresholds by tempering both receptor-dependent and receptor-independent signaling. Conventional therapeutic interventions and other targets have demonstrated limitations, suggesting that CD19 is a viable target for lymphoma treatment. There are several FDA-approved anti-CD19 CAR-T cells, including Axicabtagene Ciloleucel, Tisagenlecleucel, and Lisocabtagene Maraleucel, as well as anti-CD19 monoclonal antibodies (mABs), such as loncastuximab tesirine and tafasitamab. These agents have demonstrated efficacy in numerous clinical trials. Blinatumomab, the inaugural FDA-approved antibody to be produced using BiTE technology, has demonstrated notable benefits in clinical trials investigating its use in the treatment of B-cell acute lymphoblastic leukemia (B-ALL). Single-domain antibodies (sdAb) or nanobodies represent the nanoscale VHH fragments of heavy chain-only antibodies (HcAbs). These have been utilized in conjunction with CAR T-cells, yielding promising outcomes. In this review, we sought to explore the potential of CD19 as a promising therapeutic target for lymphoma. Furthermore, we engaged in a discourse on the various treatment options concerning CD19 targeting, accompanied by an exposition of the pertinent clinical studies. In this regard, the efficacy, safety, and limitations of each option were thoroughly delineated.

论文信息

作者
Sasan SN、Arash SS、Sana Sadat P、Sadra B、Seyed Reza B、Saeid A
单位
Cancer Biology Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.Iran
文献类型
综述
期刊
Archives of Razi Institute2025 Apr
原文标识
PubMed 41179632 · DOI 10.32592/ARI.2025.80.2.301