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嵌合抗原受体T细胞疗法治疗骨髓瘤和淋巴瘤的综述

A Review of Chimeric Antigen Receptor T-Cell Therapy for Myeloma and Lymphoma.

作者信息

Atrash Shebli, Moyo Tamara K

机构信息

Plasma Cell Disorders Division, Department of Hematologic Oncology & Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, NC, USA.

Lymphoma Division, Department of Hematologic Oncology & Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, NC, USA.

出版信息

Onco Targets Ther. 2021 Mar 26;14:2185-2201. doi: 10.2147/OTT.S242018. eCollection 2021.

Abstract

Collectively, hematological malignancies account for the fourth most common malignancy. Myeloma and lymphoma are the most common types of hematological malignancies. Unfortunately, the management of refractory myeloma and lymphoma remains challenging. The discovery of new immunological therapies, namely chimeric antigen receptors T cells (CAR-T), outlined unprecedented B cell malignancies results. In this context, the CAR-T-based approach has led to the proliferation of many clinical studies. In this review, we will deal with the CAR-T structure, and we will summarize the primary clinical studies assessing the risks and benefits of CAR-T cell therapy. We will also deal with the adverse events and management of cytokine release syndromes/immune effector cell-associated neurotoxicity syndrome (ICANS). Subsequently, we will review potential future improvements to overcome refractoriness and improve expansion while decreasing CAR-T's off-target effects. The advances in the CAR-T platform represent a step forward with promising unlimited future possibilities that made it a paradigm-shifting for the management of B cell malignancies.

摘要

血液系统恶性肿瘤总体上是第四大常见恶性肿瘤。骨髓瘤和淋巴瘤是血液系统恶性肿瘤最常见的类型。不幸的是,难治性骨髓瘤和淋巴瘤的治疗仍然具有挑战性。新免疫疗法即嵌合抗原受体T细胞(CAR-T)的发现,带来了前所未有的B细胞恶性肿瘤治疗成果。在此背景下,基于CAR-T的方法引发了众多临床研究。在本综述中,我们将探讨CAR-T的结构,并总结评估CAR-T细胞疗法风险和益处的主要临床研究。我们还将探讨细胞因子释放综合征/免疫效应细胞相关神经毒性综合征(ICANS)的不良事件及管理。随后,我们将回顾未来潜在的改进措施,以克服难治性并在减少CAR-T脱靶效应的同时促进其扩增。CAR-T平台的进展代表了向前迈进的一步,具有无限的未来可能性,使其成为B细胞恶性肿瘤治疗的范式转变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7e5/8009535/1abf0116beda/OTT-14-2185-g0001.jpg

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