Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
Lymphoid Malignancies Program, Staff Physician, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland, OH, USA.
Expert Opin Biol Ther. 2021 Apr;21(4):435-441. doi: 10.1080/14712598.2021.1889510. Epub 2021 Mar 11.
: The therapeutic options for mantle cell lymphoma (MCL) include traditional chemo-immunotherapy for newly diagnosed cases, and targeted treatments including the bruton tyrosine kinase inhibitors in the relapsed/refractory (R/R) disease setting. The advent of commercially available chimeric antigen receptor (CAR) T-cell therapy in the last three years has dramatically improved the outcomes of patients with R/R large B-cell lymphoma.: This review is an in-depth evaluation and appraisal of brexucabtagene autoleucel (brexu-cel), the first anti-CD19 CAR T-cell therapy to be approved for patients with R/R MCL, after the results of a Phase II (ZUMA-2) trial.: In the absence of head-to-head comparison studies with Btk inhibitors, up-front use of brexu-cel in patients with high-risk MCL and poor prognostic features may be advantageous, possibly even before exposure to Btk inhibitor, and further study of this approach is warranted. While data on long-term outcomes of CAR T-cell therapy in MCL patients are needed, brexu-cel has shown remarkable clinical activity and its regulatory approval has immediate practice-changing implications in this highly aggressive malignancy.
: 套细胞淋巴瘤（MCL）的治疗选择包括新诊断病例的传统化疗免疫治疗，以及在复发/难治（R/R）疾病环境中的靶向治疗，包括布鲁顿酪氨酸激酶抑制剂。在过去三年中，商业上可获得的嵌合抗原受体（CAR）T 细胞疗法的出现极大地改善了 R/R 大 B 细胞淋巴瘤患者的预后。: 这篇综述深入评估和评价了 brexucabtagene autoleucel（brexu-cel），这是第一种获批用于 R/R MCL 的抗 CD19 CAR T 细胞疗法，基于一项 II 期（ZUMA-2）试验的结果。: 在缺乏与 BTK 抑制剂头对头比较研究的情况下，在高危 MCL 和预后不良特征的患者中早期使用 brexu-cel 可能是有利的，甚至可能在接触 BTK 抑制剂之前，进一步研究这种方法是有必要的。虽然需要更多关于 CAR T 细胞治疗在 MCL 患者中的长期疗效数据，但 brexu-cel 已显示出显著的临床活性，其监管批准对这种高度侵袭性恶性肿瘤具有直接改变实践的意义。
