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lisocabtagene maraleucel CAR-T 细胞在结内和胃肠道滤泡性淋巴瘤中的新兴作用

英文原题:Emerging role of lisocabtagene maraleucel chimeric antigen receptor-T cell in nodal and gastrointestinal follicular lymphoma.

查看英文原题

Emerging role of lisocabtagene maraleucel chimeric antigen receptor-T cell in nodal and gastrointestinal follicular lymphoma.

PubMed 2025/12/07(内容时间) World J Gastroenterol Q1 · IF 7.7(JCR 2025)

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中文摘要

嵌合抗原受体(CAR)-T 细胞疗法已成为复发/难治性滤泡性淋巴瘤(FL)的一种变革性治疗选择,尤其是在多线常规治疗失败的患者中。在靶向分化簇(CD)19的产品中,lisocabtagene maraleucel(liso-cel)因其明确的 CD4+/CD8+ 组成和良好的安全性特征而具有独特优势。与弥漫性大 B 细胞淋巴瘤相比,FL 患者始终获得更高的总缓解率,并且表现出更低的重度细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性综合征发生率,这支持了在该亚组中扩大 CAR-T 细胞治疗的理由。

本社论回顾了当前靶向 CD19 的 CAR-T 细胞治疗格局,重点关注关键的 TRANSCEND FL 试验,该试验显示总缓解率为 97%,完全缓解率为 94%,重度 CRS 或神经毒性发生率极低。比较性见解突出了 liso-cel 相较于其他 CAR-T 细胞产品(如 axicabtagene ciloleucel 和 tisagenlecleucel)在毒性、物流和门诊可行性方面的优势。本文还讨论了其对胃肠道 FL(GI-FL)的意义,该亚型常被排除在 CAR-T 细胞研究之外,并强调有必要在未来的评估中纳入晚期 GI-FL 病例。随着生产、可及性和生物标志物开发的持续改进,liso-cel 有望成为 FL 不断演变的治疗范式中的核心组成部分。

然而,在缓解持久性、成本和可及性方面仍存在挑战,值得仔细讨论。

展开英文摘要原文

Chimeric antigen receptor (CAR)-T cell therapy has emerged as a transformative treatment option for relapsed or refractory follicular lymphoma (FL), particularly in patients in whom multiple lines of conventional therapy have failed. Among cluster of differentiation (CD) 19-targeted products, lisocabtagene maraleucel (liso-cel) offers distinct advantages owing to its defined CD4 + /CD8 + composition and favorable safety profile. Compared with diffuse large B-cell lymphoma, FL patients consistently achieve higher overall response rates and exhibit lower rates of severe cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome, supporting the rationale for expanding CAR-T cell therapy in this subgroup.

This editorial review the current CD19-directed CAR-T cell therapy landscape, focusing on the pivotal TRANSCEND FL trial, which demonstrated a 97% overall response rate and 94% complete response rate, with a minimal incidence of severe CRS or neurotoxicity. Comparative insights highlight the advantages of liso-cel over other CAR-T cell products, such as axicabtagene ciloleucel and tisagenlecleucel in terms of toxicity, logistics, and outpatient feasibility.

The implications for gastrointestinal FL (GI-FL), a subtype often excluded from CAR-T cell studies, were also addressed, emphasizing the need to include advanced-stage GI-FL cases in future evaluations. With ongoing improvements in manufacturing, accessibility, and biomarker development, liso-cel is well-positioned to become a central component in the evolving treatment paradigm for FL.

However, challenges remain regarding durability of response, cost, and access, which warrant careful discussion.

论文信息

作者
Watanabe T
单位
Department of Internal Medicine and Gastroenterology, Watanabe Internal Medicine Aoyama Clinic, Niigata 9502002, Japan. nabetaku@dia-net.ne.jp.Japan
文献类型
社论
期刊
World journal of gastroenterology2025 Dec 7
原文标识
PubMed 41378337 · DOI 10.3748/wjg.v31.i45.112336