Lulla Premal D, Hill LaQuisa C, Ramos Carlos A, Heslop Helen E
Baylor College of Medicine, Houston, Texas.
Clin Adv Hematol Oncol. 2018 May;16(5):375-386.
Resistance to conventional lines of therapy develops in approximately 20% of all patients with lymphoma. These patients have a dismal prognosis, with an expected median survival of 6.3 months. In recent years, T-cell immunotherapy has demonstrated a remarkable capacity to induce complete and durable clinical responses in patients with chemotherapy-refractory lymphoma. A major contributor to the success of immunotherapy has been the advent of genetic engineering technologies that introduce a chimeric antigen receptor (CAR) into T cells to focus their killing activity on tumor cells. The adoptive transfer of autologous CAR T-cell products specific for the pan-B-cell antigen CD19 have now received approval from the US Food and Drug Administration (FDA) for the treatment of relapsed or chemotherapy-resistant B-cell non-Hodgkin lymphoma. This review is designed to showcase the clinical efficacy and unique toxicities of individually developed CAR T-cell products for the treatment of lymphomas and their evolution from the laboratory bench to commercialization.
在所有淋巴瘤患者中,约20%会对传统治疗方案产生耐药性。这些患者的预后很差,预期中位生存期为6.3个月。近年来,T细胞免疫疗法已显示出在化疗难治性淋巴瘤患者中诱导完全且持久临床反应的显著能力。免疫疗法成功的一个主要因素是基因工程技术的出现,该技术将嵌合抗原受体(CAR)引入T细胞,使其杀伤活性集中于肿瘤细胞。针对泛B细胞抗原CD19的自体CAR T细胞产品的过继性转移现已获得美国食品药品监督管理局(FDA)批准,用于治疗复发或化疗耐药的B细胞非霍奇金淋巴瘤。本综述旨在展示个体化开发的CAR T细胞产品在治疗淋巴瘤方面的临床疗效和独特毒性,以及它们从实验室到商业化的发展历程。