肿瘤细胞治疗研究
英文原题：With BiTEs at the kiddie table, where do CARs come in for pediatric B-ALL?
With BiTEs at the kiddie table, where do CARs come in for pediatric B-ALL?
分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。
T 细胞衔接免疫疗法已改变了儿童 B 细胞急性淋巴细胞白血病（B-ALL）的治疗。
T细胞衔接免疫疗法已改变了儿童B细胞急性淋巴细胞白血病（B-ALL）的治疗。这些疗法首先革新了复发/难治性疾病的结局，目前正被纳入一线治疗并开展研究。随着美国食品药品监督管理局（FDA）批准CD19靶向双特异性T细胞衔接器（BiTE）blinatumomab用于缓解巩固治疗，大多数B-ALL患者在一线治疗中接受blinatumomab。靶向CD19的嵌合抗原受体（CAR）T细胞疗法已获FDA批准，用于难治性或第二次及以上复发的儿童B-ALL患者。由于具有相同靶点、相似作用机制以及部分重叠的适应证，这些免疫疗法的最佳定位和顺序仍不明确。本文综述了blinatumomab和CAR-T 细胞疗法的最新数据及扩展应用，并讨论了CAR-T 细胞疗法在当前儿童B-ALL治疗格局中的作用，包括在复发/难治性疾病患者以及极高复发风险人群中的作用。
T-cell engaging immunotherapies have transformed the treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL). First revolutionizing outcomes for relapsed and refractory disease, these therapies are now being incorporated and studied in the frontline setting. With the US Food and Drug Administration (FDA) approval of the CD19-directed bispecific T-cell engager (BiTE) blinatumomab for remission consolidation, the majority of patients with B-ALL receive blinatumomab in frontline therapy. Chimeric antigen receptor (CAR) T-cell therapy targeting CD19 is FDA approved for pediatric patients with B-ALL that is refractory or in second or greater relapse. With the same target, similar mechanisms of action, and some overlap in indications, the optimal placement and sequence of these immunotherapies remain unclear. Here we review the recent data and expanded use of blinatumomab and CAR T-cell therapy and discuss the role of CAR T-cell therapy in the current pediatric B-ALL treatment landscape, including in populations with relapsed/refractory disease and at very high risk of relapse.
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