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优化 ciltacabtagene autoleucel 治疗结局:单一学术中心的真实世界经验与最佳实践

英文原题:Optimizing ciltacabtagene autoleucel outcomes: real-world experience and best practices from a single academic center.

查看英文原题

Optimizing ciltacabtagene autoleucel outcomes: real-world experience and best practices from a single academic center.

PubMed 2026/07/06(内容时间) Front Oncol Q2 · IF 3.4(JCR 2025)

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

中文摘要

西达基奥仑赛(cilta-cel)是一种靶向B细胞成熟抗原(BCMA)的CAR-T 细胞疗法,已改变了复发/难治性多发性骨髓瘤的治疗格局,并在患者中展现出长期无治疗缓解(CARTITUDE-1:中位总生存期60.7个月,33%的患者无进展生存期达5年)。尽管关键临床试验已证实了前所未有的缓解深度和持久性,但真实世界人群有时可能与符合试验条件的队列存在差异,其年龄变异性更大、合并症负担更重、功能受限更多,以及可能影响结局的后勤挑战。随着cilta-cel在治疗中心、社区及门诊环境中的推广应用,生成真实世界证据和最佳实践对于确保该疗法的变革性潜力得以安全有效地实现至关重要。这是一份关于我们实施cilta-cel经验的单中心报告。

我们分享在整个治疗连续过程中支持良好安全性和临床结局的实用策略——从患者选择、基线风险评估和输注前优化开始,到不良事件的急性监测和管理,再到长期随访。

我们强调结构化工作流程、多学科协调、早期转诊路径、预期性指导和协作护理模式在实现安全有效结局中的重要性。随着各中心不断优化cilta-cel的实施,这些机构见解将在塑造接受CAR-T 治疗患者的最佳实践方面发挥关键作用。

展开英文摘要原文

Ciltacabtagene autoleucel (cilta-cel), a B-cell maturation antigen (BCMA)-directed chimeric antigen receptor T-cell (CAR-T) therapy, has transformed the management of relapsed or refractory multiple myeloma and demonstrated long-term, treatment-free remissions in patients (CARTITUDE-1: median overall survival, 60. 7 months and 33% of patients with progression-free survival 5 years).

While pivotal clinical trials have demonstrated unprecedented depth and durability of response, the real-world populations can sometimes diverge from trial-eligible cohorts, with greater age variability, comorbidity burden, functional limitations, and logistic challenges that may impact outcomes.

As cilta-cel adoption expands across treatment centers into the community and outpatient settings, generating real-world evidence and best practices is critical to ensuring that the transformative potential of this therapy is realized safely and effectively. This is a single-center report on our experience implementing cilta-cel.

We share practical strategies that have supported favorable safety and clinical outcomes across the treatment continuum-beginning with patient selection, baseline risk assessment and pre-infusion optimization, through acute monitoring and management of adverse events, to longer-term follow-up.

We highlight the importance of structured workflows, multidisciplinary coordination, early referral pathways, anticipatory guidance, and collaborative care models in achieving safe and effective outcomes. As centers continue to refine cilta-cel implementation, these institutional insights will play a key role in shaping best practices for patients receiving CAR-T therapy.

论文信息

作者
Shune LO、Mahmoudjafari Z、McGuirk JP
单位
Division of Hematologic Malignancies and Cellular Therapeutics, The University of Kansas Medical Center, Kansas, KS, United States.United States
期刊
Frontiers in oncology2026
原文标识
PubMed 42518817 · DOI 10.3389/fonc.2026.1841031