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:Chimeric antigen receptor T-cell and bispecific antibody therapies for follicular lymphoma: Recent advances and future prospects.
滤泡性淋巴瘤患者由于疾病进展缓慢,预期生存期相对较长,但该病通常会反复复发且无法治愈。
滤泡性淋巴瘤患者由于疾病进展缓慢,预期生存期相对较长,但该病通常反复复发且无法治愈。因此,开发针对复发或难治性滤泡性淋巴瘤的治疗方法是一个紧迫问题。近年来细胞免疫治疗的引入显著改变了B细胞恶性肿瘤的治疗格局。针对滤泡性淋巴瘤的抗CD19嵌合抗原受体(CAR)-T细胞疗法和CD20 CD3双特异性抗体疗法的临床开发正在进行中。多项研究也报道了CAR-T细胞和双特异性抗体疗法对复发或难治性滤泡性淋巴瘤的疗效,部分细胞免疫治疗已在日本获批。虽然CAR-T疗法高度有效,并可能使部分患者获得功能性治愈,但其面临可及性有限、成本高昂和毒性较高等挑战。相比之下,双特异性抗体毒性相对较轻,可广泛用于一般状况较差的患者,包括老年患者,但存在长期给药负担等问题。最佳患者选择、独特毒性的管理以及高昂成本仍是细胞免疫治疗需要解决的问题。本综述总结了细胞免疫治疗用于滤泡性淋巴瘤的最新临床数据。
Patients with follicular lymphoma are expected to have relatively long survival due to slow disease progression, but the disease generally relapses repeatedly and remains incurable. Therefore, development of treatments for relapsed or refractory follicular lymphoma is an urgent issue. The recent introduction of cellular immunotherapy has significantly changed treatment of B-cell malignancies. Clinical development of anti-CD19 chimeric antigen receptor (CAR)-T cell therapy and CD20 CD3 bispecific antibody therapy for follicular lymphoma is underway. Multiple studies have also reported the effectiveness of CAR-T cell and bispecific antibody therapies for relapsed or refractory follicular lymphoma, and some cellular immunotherapies have already been approved in Japan. While CAR-T therapy is highly effective and may offer a functional cure in some patients, it faces challenges such as limited access, high cost, and high toxicities. Bispecific antibodies, in contrast, have relatively mild toxicities and can be widely used in patients with poor general conditions, including elderly patients, but have problems such as the burden of long-term administration. Optimal patient selection, management of unique toxicities, and high costs remain issues to be resolved for cellular immunotherapy. This review summarizes the recent clinical data on cellular immunotherapy for follicular lymphoma.
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