The affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, 127 Dongming Road, Zhengzhou, 450008, China.
J Hematol Oncol. 2018 Mar 15;11(1):41. doi: 10.1186/s13045-018-0593-5.
The prognosis of adults with relapsed/refractory (R/R) acute lymphoblastic leukemia (ALL) remains dismal even at this day and age. With salvage chemotherapy, only 29% (range 18 to 44%) of the patients with R/R ALL can be induced into complete remission (CR), with a median overall survival (OS) of 4 months (range 2-6 months). Blinatumomab and inotuzumab ozogamycin (IO) are immunotherapeutic agents that increased CR to 80% and extended survival to 7.7 months in this high-risk population of patients. In the last few years, chimeric antigen receptor (CAR)--engineered T cells have led to major progress in cancer immunotherapy. CD-19 CAR-T cells have been recently approved for high-risk R/R ALL and lymphoma. The data from long-term follow-up of a single-center phase I study of 19-28z CAR-T cell therapy for adult R/R ALL were just published. At the same time, a multicenter phase II study of 19-41BB CAR-T cell therapy for children and young adults with R/R B cell ALL was also published. The two studies provided fresh information with long-term follow-up. This research highlight analyzed the data and proposed future perspectives for further investigation in this rapidly evolving field.
即使在今天,复发/难治性(R/R)急性淋巴细胞白血病(ALL)成人患者的预后仍然不容乐观。采用挽救性化疗,仅有 29%(范围 18 至 44%)的 R/R ALL 患者可诱导完全缓解(CR),中位总生存期(OS)为 4 个月(范围 2-6 个月)。blinatumomab 和 inotuzumab ozogamycin(IO)是免疫治疗药物,可将这一高危患者群体的 CR 率提高至 80%,并将生存时间延长至 7.7 个月。在过去几年中,嵌合抗原受体(CAR)-修饰的 T 细胞在癌症免疫治疗方面取得了重大进展。CD-19 CAR-T 细胞最近已被批准用于高危 R/R ALL 和淋巴瘤。一项单中心 19-28z CAR-T 细胞治疗成人 R/R ALL 的 I 期研究的长期随访数据刚刚公布。与此同时,一项多中心 19-41BB CAR-T 细胞治疗儿童和青少年 R/R B 细胞 ALL 的 II 期研究也已发表。这两项研究提供了长期随访的最新信息。本研究亮点分析了数据,并为该快速发展领域的进一步研究提出了未来展望。