Cheson Bruce D
Department of Hematology, Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC 20007, USA.
Semin Oncol. 2006 Apr;33(2 Suppl 5):S2-14. doi: 10.1053/j.seminoncol.2006.01.024.
For decades, chemotherapy was the only available approach for patients with advanced lymphoid malignancies. Treatment paradigms were dramatically altered by the availability of novel and active targeted agents, particularly the monoclonal antibodies, alemtuzumab and rituximab. These agents are now playing an increasingly important role in the treatment of lymphoid malignancies. Alemtuzumab is being used earlier in the course of chronic lymphocytic leukemia in patients with a more intact immune system, when it is likely to have its greatest activity. The immunosuppressive properties of monoclonal antibodies are also being explored in the stem cell transplant setting, including in vivo purging and, with alemtuzumab, for the management of graft-versus-host disease. Rituximab has become ubiquitous in the treatment of most B-cell malignancies. Further research with this antibody is focused on optimizing its use and determining its role in each of the relevant disease states. In addition, newer antibodies are in development for treating chronic lymphocytic leukemia and other B-cell malignancies. New treatment regimens, including combinations of monoclonal antibodies, could enhance complete response rates and prolong progression-free survival, perhaps eventually improving our ability to cure patients with lymphoid malignancies.
几十年来，化疗一直是晚期淋巴系统恶性肿瘤患者唯一可用的治疗方法。新型活性靶向药物的出现，特别是单克隆抗体阿仑单抗和利妥昔单抗，极大地改变了治疗模式。这些药物如今在淋巴系统恶性肿瘤的治疗中发挥着越来越重要的作用。对于免疫系统相对完整的慢性淋巴细胞白血病患者，阿仑单抗在病程早期使用时可能具有最大活性。单克隆抗体的免疫抑制特性也在干细胞移植领域进行探索，包括体内清除，以及使用阿仑单抗治疗移植物抗宿主病。利妥昔单抗在大多数B细胞恶性肿瘤的治疗中已广泛应用。对这种抗体的进一步研究集中在优化其使用方法，并确定其在每种相关疾病状态中的作用。此外，正在研发用于治疗慢性淋巴细胞白血病和其他B细胞恶性肿瘤的新型抗体。包括单克隆抗体联合使用的新治疗方案，可能会提高完全缓解率并延长无进展生存期，或许最终能提高我们治愈淋巴系统恶性肿瘤患者的能力。
