CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Hematologic malignancies and an overview of emerging therapies for hematologic malignancies: a systematic review.
Hematologic malignancies and an overview of emerging therapies for hematologic malignancies: a systematic review.
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血液系统恶性肿瘤由于疾病异质性、治疗耐药以及传统治疗相关的显著毒性,仍然是主要的治疗挑战。近年来,分子肿瘤学和免疫治疗的快速进展促成了多种新兴治疗策略的开发。本综述综合了关于新方法的证据,包括靶向治疗,如 BTK 抑制剂(例如 ibrutinib)、BCL-2 抑制剂(例如 venetoclax)、FLT3 和 JAK 抑制剂,以及增强免疫介导细胞毒性的下一代单克隆抗体和双特异性抗体。
此外,基于基因和细胞的方式——包括 CAR-T 细胞治疗和 CRISPR 介导的基因校正——已显示出有前景的疗效,尤其是在复发/难治性白血病和淋巴瘤中。尽管取得了这些进展,仍存在显著局限性,包括治疗相关毒性、耐药机制、CAR-T 治疗后的高复发率,以及巨大的经济负担和可及性障碍。预测性生物标志物、治疗的最佳排序以及长期安全性方面的空白也限制了广泛实施。由分子诊断和基因组分析驱动的精准医学方法持续优化个体化治疗策略,并具有克服当前挑战的潜力。
总体而言,本综述对血液系统恶性肿瘤中的新兴治疗方式提供了更新的、全面的评估,并概述了亟需进一步研究的关键领域。
Hematologic malignancies remain a major therapeutic challenge due to disease heterogeneity, treatment resistance, and significant toxicity associated with conventional therapies. In recent years, rapid advances in molecular oncology and immunotherapy have led to the development of multiple emerging therapeutic strategies.
This review synthesizes evidence on novel approaches, including targeted therapies such as BTK inhibitors (e. g. , ibrutinib), BCL-2 inhibitors (e. g. , venetoclax), FLT3 and JAK inhibitors, and next-generation monoclonal and bispecific antibodies that enhance immune-mediated cytotoxicity.
In addition, gene- and cell-based modalities-including CAR T-cell therapy and CRISPR-mediated gene correction-have demonstrated promising efficacy, particularly in relapsed or refractory leukemia and lymphoma. Despite these advances, significant limitations remain, including treatment-related toxicities, mechanisms of resistance, high relapse rates after CAR-T therapy, and substantial financial and accessibility barriers.
Gaps in predictive biomarkers, optimal sequencing of therapies, and long-term safety also limit widespread implementation. Precision medicine approaches, driven by molecular diagnostics and genomic profiling, continue to refine individualized treatment strategies and hold potential to overcome current challenges.
Overall, this review provides an updated and comprehensive evaluation of emerging therapeutic modalities in hematologic malignancies and outlines key areas where further research is critically needed.
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