Alcantara Marion, Fuentealba Jaime, Soussain Carole
Center for Cancer Immunotherapy, Institut Curie, PSL Research University, INSERM U932, 75005 Paris, France.
Clinical Hematology Unit, Institut Curie, 92210 Saint-Cloud, France.
Cancers (Basel). 2021 Oct 10;13(20):5061. doi: 10.3390/cancers13205061.
Primary central nervous system lymphoma (PCNSL) is, mainly, a diffuse large B-cell lymphoma (DLBCL) with a non-germinal center B-cell (non-GCB) origin. It is associated with a poor prognosis and an unmet medical need. Immunotherapy has emerged as one of the most promising areas of research and is now part of the standard treatment for many solid and hematologic tumors. This new class of therapy generated great enthusiasm for the treatment of relapsed/refractory PCNSL. Here, we discuss the challenges of immunotherapy for PCNSL represented by the lymphoma cell itself and the specific immune brain microenvironment. We review the current clinical development from the anti-CD20 monoclonal antibody to CAR-T cells, as well as immune checkpoint inhibitors and targeted therapies with off-tumor effects on the brain microenvironment. Perspectives for improving the efficacy of immunotherapies and optimizing their therapeutic role in PCNSL are suggested.
原发性中枢神经系统淋巴瘤（PCNSL）主要是一种起源于非生发中心B细胞（non-GCB）的弥漫性大B细胞淋巴瘤（DLBCL）。它与预后不良和未满足的医疗需求相关。免疫疗法已成为最有前景的研究领域之一，现在是许多实体瘤和血液系统肿瘤标准治疗的一部分。这类新疗法引发了对复发/难治性PCNSL治疗的极大热情。在此，我们讨论以淋巴瘤细胞本身和特定免疫脑微环境为代表的PCNSL免疫治疗挑战。我们回顾了从抗CD20单克隆抗体到CAR-T细胞的当前临床进展，以及对脑微环境具有肿瘤外效应的免疫检查点抑制剂和靶向疗法。提出了提高免疫疗法疗效并优化其在PCNSL中治疗作用的前景。
