Department of Medical Oncology, Dana Farber Cancer Institute , Boston , MA , USA.
Expert Opin Biol Ther. 2019 Nov;19(11):1157-1164. doi: 10.1080/14712598.2019.1644316. Epub 2019 Jul 25.
: Traditionally, outcomes for patients with relapsed/refractory aggressive B-cell non-Hodgkin lymphoma have been poor. There has been a clear need for effective therapeutic options that could produce durable remissions with a reasonable safety profile. The approval of chimeric antigen receptor (CAR) T-cell therapies has been revolutionary in the field because CAR T-cells meet this need for a substantial number of patients. With multiple approved CAR T-cell products and more expected soon, it can be difficult to distinguish between the various products and decide which to use. Effective CAR T-cell therapeutic choice is enhanced by an understanding of the biology of CAR T-cell, as well as the mechanisms associated with both efficacy and toxicity. : Biology of CAR T-cells, as well as a discussion of their efficacy and toxicity. Mechanisms of resistance, current unanswered questions in the field, issues associated with choosing a CAR T-cell product, and future directions for the advancement of CAR T-cell therapy. : Due to differences in study populations and manufacturing times, it is too early to know if there is a 'best' choice for CAR T-cell therapy. Decisions must be individualized taking into account patient factors and expected toxicity.
: 传统上,复发/难治性侵袭性 B 细胞非霍奇金淋巴瘤患者的预后较差。显然需要有效的治疗选择,这些选择能够产生持久的缓解,同时具有合理的安全性。嵌合抗原受体 (CAR) T 细胞疗法的批准在该领域具有革命性意义,因为 CAR T 细胞满足了大量患者的这一需求。随着越来越多的 CAR T 细胞产品获得批准,并且预计很快会有更多的产品获得批准,因此很难区分各种产品并决定使用哪种产品。通过了解 CAR T 细胞的生物学特性,以及与疗效和毒性相关的机制,有助于做出有效的 CAR T 细胞治疗选择。: 包括 CAR T 细胞的生物学特性,以及对其疗效和毒性的讨论。耐药机制、该领域目前尚未解决的问题、选择 CAR T 细胞产品的相关问题以及 CAR T 细胞治疗的未来发展方向。: 由于研究人群和制造时间的差异,目前还为时过早,无法确定 CAR T 细胞治疗是否有“最佳”选择。必须根据患者因素和预期毒性进行个体化决策。
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