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多发性骨髓瘤中抗 BCMA CAR-T 细胞治疗前桥接治疗的经验与专家小组共识

英文原题:Experiences and expert panel consensus on bridging therapy before anti-BCMA CAR-T cell therapy in multiple myeloma.

PubMed 2026/05/13(内容时间) Bone Marrow Transplant Q1 · IF 5.1(JCR 2025)

研究概要

使用抗 B 细胞成熟抗原(BCMA)CAR-T 细胞疗法治疗复发/难治性多发性骨髓瘤的情况正在增加。

中文摘要

靶向 B 细胞成熟抗原(BCMA)的CAR-T 细胞疗法在复发/难治性多发性骨髓瘤中的应用日益增加。研究提示,在抗 BCMA CAR-T 治疗前采用有效的桥接治疗(BT),可改善疗效和安全性结局。通过定性访谈和共识研讨会,10 位欧洲专家分享了关于最佳 BT 选择、疗效、安全性和 CAR-T 后结局的临床经验,重点讨论接受多线治疗患者及双特异性 T 细胞衔接剂等新兴 BT 选项。专家一致认为,BT 应以降低肿瘤负荷并维持或改善患者体能状态为目标,同时避免治疗相关毒性导致 CAR-T 输注延迟或无法进行。治疗持续时间与获得充分应答之间需要平衡;对难治人群而言,患者特征是选择 BT 的关键。本文讨论独特疗法 talquetamab(一种 GPRC5D×CD3 双特异性抗体),其在临床试验中显示强效且应答迅速;结合专家经验和真实世界数据,该药正被考虑作为抗 BCMA CAR-T 前的桥接治疗选择。这份基于临床经验的共识旨在为参与抗 BCMA CAR-T 治疗的医疗专业人员提供 BT 指导,并帮助这一快速发展的领域实现照护标准化。

展开英文摘要原文

Use of anti-B-cell maturation antigen (BCMA) chimeric antigen receptor T-cell (CAR-T) therapy to treat relapsed/refractory multiple myeloma is increasing. Studies suggest that effective bridging therapy (BT) prior to anti-BCMA CAR-T therapy can enhance efficacy and safety outcomes. Through qualitative interviews and a consensus workshop, 10 European experts shared their clinical experience regarding optimal BT selection, efficacy, safety and outcomes post-CAR-T, focussing on heavily pretreated patients and emerging BT options, such as bispecific T-cell engagers. Experts agreed that BT should aim to reduce tumour burden and maintain or improve patient performance status, while avoiding treatment-related toxicity that could delay or prevent CAR-T infusion. The balance between treatment duration and achieving an adequate response is important, and patient characteristics are key for BT selection, especially in difficult-to-treat populations. Here, we discuss the unique therapy talquetamab, a GPRC5DxCD3 bispecific antibody, which demonstrates robust efficacy and rapid response rates in clinical trials, and is being considered as a BT option before anti-BCMA CAR-T therapy based on expert experience and real-world data. This consensus, based on clinical experience, aims to provide guidance on BT for healthcare professionals (HCPs) involved in anti-BCMA CAR-T therapy and aid standardisation of care in this rapidly advancing field.

论文信息

作者
Rasche L、Krauth MT、Agis H、Renner C、Strassl I、Teipel R、Vučinić V、Weisel K
单位
University Hospital Würzburg, Würzburg, Germany. Rasche_L@ukw.de.Germany
文献类型
共识声明
期刊
Bone marrow transplantation2026 Jul
原文标识
PubMed 42129310 · DOI 10.1038/s41409-026-02905-1