决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Immunotherapy of diffuse large B-cell lymphoma: from monoclonal antibodies to cellular therapies. A narrative review.
标准一线免疫化疗对约 60% 的 DLBCL 病例有效,而 30-40% 出现复发或难治性疾病,这凸显了亟需更有效的治疗策略。
B细胞淋巴瘤(BCL)是一组异质性血液肿瘤,免疫疗法已显著改变其治疗格局。抗CD20单克隆抗体利妥昔单抗联合化疗(R-CHOP)显著改善了患者结局。然而,部分亚型,尤其弥漫性大B细胞淋巴瘤(DLBCL),仍因频繁复发和/或早期治疗耐药而难以治疗。约60%的DLBCL患者可从标准一线免疫化疗中获益,另有30%–40%复发或呈难治性,凸显了对更有效治疗策略的迫切需求。近期,研究者已探索多种先进免疫疗法,包括新型双特异性和三特异性抗体、抗体-药物偶联物及免疫检查点抑制剂。此外,CAR-T和CAR-NK细胞等基于免疫效应细胞的疗法也已开发。其中,靶向CD19的CAR-T疗法在复发或难治性DLBCL患者中取得较高缓解率,已成为新的关键治疗选择。本叙述性综述概述当前DLBCL免疫治疗,包括相关作用机制、临床结局及安全性特征。
B-cell lymphomas (BCLs) are a heterogeneous group of blood cancers whose treatment has been significantly transformed by immunotherapy. The use of the anti-CD20 monoclonal antibody rituximab, combined with chemotherapy (R-CHOP), has markedly improved patient outcomes. However, some subtypes, particularly Diffuse Large B-Cell Lymphoma (DLBCL), remain challenging to treat due to frequent relapses and/or early resistance to therapy. Standard frontline immunochemotherapy is successful in about 60% of DLBCL cases, whereas 30-40% experience relapse or refractory disease, thus highlighting the urgent need for more effective therapeutic strategies. More recently, advanced immunotherapies have been investigated, relying on the use of innovative bi- and trispecific antibodies, antibody-drug conjugates, and immune checkpoint inhibitors. Furthermore, immune effector cell-based therapies, such as CAR-T and CAR-NK cells, have been developed. Among these, CAR-T cell therapy targeting CD19 achieved high response rates in patients with relapsed or refractory DLBCL, emerging as new pivotal therapeutic option. In this narrative review, we provide an overview of current immunotherapy treatments for DLBCL, including underlying mechanisms, clinical outcomes, and safety profiles.
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