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