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套细胞淋巴瘤治疗策略演变:进展与未来方向

英文原题:Evolving therapeutic strategies in mantle cell lymphoma: advancements and future directions.

查看英文原题

Evolving therapeutic strategies in mantle cell lymphoma: advancements and future directions.

PubMed 2026/04/15(内容时间) Leukemia Q1 · IF 8.8(JCR 2025)

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中文摘要

套细胞淋巴瘤(MCL)是一种在生物学和临床上具有异质性的B细胞恶性肿瘤,历史上预后较差。近期进展已大幅扩展了治疗选择,尤其是通过整合靶向治疗、无化疗方案和细胞疗法。一线治疗现已纳入Bruton酪氨酸激酶抑制剂(BTKi)联合化疗以及无化疗方案。对于复发/难治性疾病患者,尤其是既往暴露于BTKi者,CAR-T 细胞疗法和第三代BTKi如pirtobrutinib提供了高效选择,同时包括双特异性抗体(bsAbs)在内的多种新型药物正在研究中。然而,实现持久缓解仍是一大挑战,尤其是在高危患者中。未来方向包括优化序贯治疗、完善合理的联合治疗、扩大bsAbs的应用,以及整合小分子和新型免疫偶联物以提高疗效和长期结局。本综述概述了MCL当前和新兴的治疗方法,强调生物制剂、策略性联合和以患者为中心的方法的整合如何推动MCL治疗的下一阶段。

展开英文摘要原文

Mantle cell lymphoma (MCL) is a biologically and clinically heterogeneous B-cell malignancy with a historically poor prognosis. Recent advances have substantially expanded treatment options, particularly through the integration of targeted therapies, chemotherapy-free regimens, and cellular approaches. Frontline treatment now incorporates Bruton's tyrosine kinase inhibitors (BTKi) in combination with chemotherapy and in chemotherapy-free regimens. For patients with relapsed or refractory disease, particularly those previously exposed to BTKi, chimeric antigen receptor T-cell (CAR T) therapies and third-generation BTKi like pirtobrutinib provide highly effective options while several novel agents, including bispecific antibodies (bsAbs), are under investigation.

Nevertheless, achieving long-lasting remissions is still a major challenge, especially among high-risk patients. Future directions include optimizing sequencing, refining rational combination therapies, expanding the application of bsAbs, and integrating small molecules and novel immunoconjugates to enhance therapeutic efficacy and long-term outcomes.

This review provides an overview of the current and emerging therapies for MCL, highlighting how the integration of biological agents, strategic combinations, and patient-centered approaches are driving the next phase of MCL treatment.

论文信息

作者
Tavarozzi R、Maher N、Catania G、Zacchi G、D'Andrea F、Sofia A、Zanni M、Ladetto M
单位
Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy. rita.tavarozzi@uniupo.it.Italy
文献类型
综述
期刊
Leukemia2026 May
原文标识
PubMed 41986622 · DOI 10.1038/s41375-026-02942-1