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.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Preclinical discovery and clinical development of glofitamab in relapsed/ refractory large B-cell lymphomas.
Preclinical discovery and clinical development of glofitamab in relapsed/ refractory large B-cell lymphomas.
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Glofitamab 提供了具有临床意义的、限时治疗,可在不符合自体 HCT 和/或 CAR-T 细胞治疗条件的患者以及 CAR-T 细胞治疗后复发的患者中实现疾病控制。
引言:复发/难治性(R/R)大B细胞淋巴瘤(LBCL)仍是临床治疗难题,尤其是原发难治或复发且不适合接受细胞治疗的患者。CD20×CD3双特异性抗体(BsAb)形式的T细胞衔接器可将内源性T细胞引导至恶性B细胞,提供有效的“现货型”治疗选择。 综述范围:本综述总结全长2:1型BsAb格菲妥单抗的临床前及转化研究进展,重点关注R/R LBCL。作者讨论其分子设计依据、作用机制及推动临床转化的临床前疗效,并回顾其在经多线治疗的R/R LBCL中单药及联合方案的临床开发里程碑、CAR-T 细胞治疗后的活性,以及向更早治疗线和老年或不适合强化治疗患者拓展的依据。本文依据PubMed及ClinicalTrials.gov收录的临床试验报告和主要试验注册信息撰写,涵盖截至2026年1月发表的文献。 专家观点:格菲妥单抗可为不适合自体造血细胞移植(HCT)和/或CAR-T 细胞治疗的患者,以及CAR-T 治疗后复发者,提供具有临床意义且疗程有限的治疗并实现疾病控制。未来需研究基于生物标志物的治疗排序、优化毒性和感染风险管理,以及提高应答持久性的联合策略。
INTRODUCTION: Relapsed/refractory (R/R) large B-cell lymphoma (LBCL) remains a clinical challenge, particularly for patients with primary refractory or relapsed disease and ineligible for cellular therapies. T-cell engagers in the form of CD20xCD3 bispecific antibodies (BsAb) offer an effective 'off-the-shelf' therapy option that redirects endogenous T cells against malignant B cells. AREAS COVERED: This review summarizes the preclinical and translational development of glofitamab, a full-length 2:1 BsAb, focusing on R/R LBCL. The authors discuss the molecular design rationale, mechanism of action, and preclinical efficacy that enabled clinical translation.
They review clinical development milestones across monotherapy and combination regimens in heavily pretreated R/R LBCL, activity after CAR T-cell therapy, and data supporting movement into earlier lines and strategies for older/unfit patients. This article is based on clinical trial reports and major trial registrations in B-cell lymphomas obtained via PubMed and ClinicalTrials. gov, covering literature published up to January 2026.
EXPERT OPINION: Glofitamab provides clinically meaningful, time-limited treatment achieving disease control in patients who are ineligible for autologous HCT and/or CAR T-cell therapy and for those relapsing after CAR T-cell therapy. Future research will be needed on biomarker-guided sequencing, optimized toxicity/infection mitigation, and combination strategies that improve durable response rates.
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