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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Novel immunotherapeutic strategies for diffuse large B-cell lymphoma: a comprehensive review.
Novel immunotherapeutic strategies for diffuse large B-cell lymphoma: a comprehensive review.
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弥漫性大B细胞淋巴瘤(DLBCL)是非霍奇金淋巴瘤中最常见的组织学亚型,具有显著的临床和生物学异质性。尽管将利妥昔单抗纳入环磷酰胺、多柔比星、长春新碱和泼尼松(R-CHOP)方案后,约60%的患者可获得持久缓解,但仍有30%-40%的患者最终出现复发或发展为难治性疾病,导致临床结局不佳。过去十年间,新型免疫治疗方法的出现重塑了复发/难治性(R/R)DLBCL的治疗格局。新兴治疗手段,包括单克隆抗体、免疫检查点抑制剂、CAR-T 细胞疗法、抗体药物偶联物和双特异性抗体,已在多种临床情境中展现出令人鼓舞的疗效。然而,耐药机制的内在复杂性,加之先进分子诊断的高昂成本和有限可及性,仍持续阻碍着疾病的最佳管理。本综述总结了DLBCL常用的治疗策略,讨论了近期进展,旨在为未来个体化治疗方案的开发提供思路。
Diffuse large B-cell lymphoma (DLBCL) represents the most prevalent histological subtype of non-Hodgkin lymphoma, characterized by pronounced clinical and biological heterogeneity. Despite the incorporation of rituximab into the cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen-achieving durable remission in approximately 60% of patients-30%-40% ultimately experience relapse or develop refractory disease, resulting in unfavorable clinical outcomes. Over the past decade, the advent of novel immunotherapeutic approaches has reshaped the therapeutic paradigm for relapsed/refractory (R/R) DLBCL.
Emerging modalities, including monoclonal antibodies, immune checkpoint inhibitors, chimeric antigen receptor T-cell (CAR-T) therapies, antibody-drug conjugates, and bispecific antibodies, have demonstrated encouraging efficacy across multiple clinical settings.
Nevertheless, the intrinsic complexity of resistance mechanisms, coupled with the substantial cost and limited accessibility of advanced molecular diagnostics, continues to hinder optimal disease management. This review summarizes the commonly used therapeutic strategies for DLBCL, discusses recent advances, and aims to provide insights for the future development of personalized treatment approaches.
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