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:Bispecific antibody combination regimens for B-cell non-Hodgkin's lymphomas.
BsAb 代表 B-NHL 治疗的一大进步,可提供高比例的深度缓解,且安全性可预测、适合门诊使用。随着试验数据不断成熟,基于 BsAb 的方案有望成为多线治疗的基础,重塑对侵袭性和惰性淋巴瘤患者的预期。
双特异性抗体(BsAbs)是一类新型免疫治疗药物,通过同时结合 CD3 和 CD20,募集内源性 T 细胞来靶向并清除恶性 B 细胞。epcoritamab、glofitamab 和 mosunetuzumab 等 BsAbs 在侵袭性和惰性 B 细胞非霍奇金淋巴瘤(B-NHL)中均显示出显著疗效,安全性总体可控。其即用型给药方式为 CAR T 细胞治疗提供了一种实用的替代选择,尤其适用于不适合移植或无法获得细胞治疗的患者。涵盖领域:本综述全面概述了 BsAbs 在 B-NHL 中的应用。我们详细介绍了复发/难治性(R/R)DLBCL、FL 和 MCL 中的关键研究,重点阐述单药治疗结果和新兴联合治疗策略。讨论了将 BsAbs 纳入细胞毒性骨架和抗体药物偶联物的方案,以及无化疗方案如 BsAbs 联合来那度胺。我们还探讨了其解决不良风险疾病特征和历史上难治性亚群的潜力。
INTRODUCTION: Bispecific antibodies (BsAbs) are a novel class of immunotherapy agents that engage endogenous T cells to target and eradicate malignant B cells by simultaneously binding CD3 and CD20. BsAbs such as epcoritamab, glofitamab, and mosunetuzumab have demonstrated substantial efficacy across both aggressive and indolent B-cell non-Hodgkin lymphomas (B-NHL), with largely manageable safety profiles. Their off-the-shelf administration offers a practical alternative to CAR T-cell therapy, particularly for patients who are transplant-ineligible or lack access to cellular approaches. AREAS COVERED: This review provides a comprehensive overview of BsAbs in B-NHL. We detail pivotal studies in relapsed/refractory (R/R) DLBCL, FL, and MCL, highlighting single-agent outcomes and emerging combination strategies. Approaches incorporating BsAbs into cytotoxic backbones and antibody-drug conjugates, as well as chemotherapy-free regimens such as BsAbs combined with lenalidomide, are discussed. We also examine their potential to address poor-risk disease features and historically refractory subsets. EXPERT OPINION: BsAbs represent a major advance in B-NHL, offering high rates of deep remission with predictable safety and outpatient feasibility. As trial data continues to mature, BsAb-based regimens are poised to become foundational across multiple lines of therapy, reshaping expectations for patients with both aggressive and indolent lymphomas.
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