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嵌合抗原受体 T 细胞靶向 B 细胞成熟抗原免疫疗法对多发性骨髓瘤具有广阔的应用前景。

Chimeric antigen receptor T cell targeting B cell maturation antigen immunotherapy is promising for multiple myeloma.

机构信息

Department of Hematology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.

出版信息

Ann Hematol. 2019 Apr;98(4):813-822. doi: 10.1007/s00277-018-03592-9. Epub 2019 Jan 28.

Abstract

Multiple myeloma (MM) remains an incurable plasma cells malignancy because of its complex genetic heterogeneity and high relapse rate post immunotherapy. The encouraging results of chimeric antigen receptor T cell (CAR-T) targeting B cell maturation antigen (BCMA) immunotherapy clinical trials have shed light on curing MM in recent years. However, many therapeutic side effects limit the promotion and clinical use of this novel effective approach such as cytokine release syndrome, antigen escape, and neurotoxicity. We should make every effort to do further study about this immunotherapy to make it safer and effective. This review focusing on this topic clarifies the following contents: present status of MM treatment, effectiveness of CAR-T cells, features of BCMA, preclinical and clinical trials of BCMA CAR-T cells therapy, and existing problems and strategies. Hoping to provide a reference for the subsequent correlative clinical and research.

摘要

多发性骨髓瘤(MM)仍然是一种不可治愈的浆细胞恶性肿瘤,因为其具有复杂的遗传异质性和高免疫治疗后复发率。嵌合抗原受体 T 细胞(CAR-T)针对 B 细胞成熟抗原(BCMA)免疫疗法的临床试验令人鼓舞的结果,近年来为治愈 MM 带来了曙光。然而,许多治疗副作用限制了这种新的有效方法的推广和临床应用,如细胞因子释放综合征、抗原逃逸和神经毒性。我们应该尽一切努力进一步研究这种免疫疗法,使其更安全、更有效。这篇综述主要讨论了以下内容:MM 治疗现状、CAR-T 细胞的疗效、BCMA 的特点、BCMA CAR-T 细胞治疗的临床前和临床试验,以及存在的问题和策略。希望为后续的相关临床和研究提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f12a/6423312/5ab855c04cbf/277_2018_3592_Fig1_HTML.jpg

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