Crees Zachary D, Ghobadi Armin
Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO 63108, USA.
Cancers (Basel). 2021 Oct 15;13(20):5181. doi: 10.3390/cancers13205181.
Non-Hodgkin Lymphoma accounts for >460,000 cases and >240,000 deaths globally and >77,000 cases and >20,000 deaths in the U.S. annually, with ~85% of cases being B-cell malignancies. Until recently, patients with relapsed/refractory B-cell lymphoma following standard chemotherapy in combination with anti-CD20 monoclonal antibodies and autologous stem cell transplantation experienced a median overall survival (OS) of <6 months. However, with the approval of four different CD-19 CAR-T therapies between 2017 and 2021, approximately 60-80% of patients receiving CAR-T therapy now achieve an objective response with >3 years median OS. Here, we review the current state of the art of CD19 CAR-T therapies for B-cell lymphomas, focusing on current updates in US FDA-approved products, along with their associated efficacy and toxicities. Lastly, we highlight a selection of promising clinical developments in the field, including various novel strategies to increase CAR-T therapy efficacy while mitigating toxicity.
非霍奇金淋巴瘤在全球每年有超过46万例病例和超过24万例死亡，在美国每年有超过7.7万例病例和超过2万例死亡，其中约85%的病例为B细胞恶性肿瘤。直到最近，在接受标准化疗联合抗CD20单克隆抗体和自体干细胞移植后复发/难治性B细胞淋巴瘤患者的中位总生存期（OS）小于6个月。然而，在2017年至2021年期间，随着四种不同的CD-19嵌合抗原受体T细胞（CAR-T）疗法获批，现在接受CAR-T疗法的患者中约60-80%实现了客观缓解，中位OS超过3年。在此，我们综述了用于B细胞淋巴瘤的CD19 CAR-T疗法的当前技术水平，重点关注美国食品药品监督管理局（FDA）批准产品的当前更新情况，以及它们相关的疗效和毒性。最后，我们强调了该领域一些有前景的临床进展，包括各种提高CAR-T疗法疗效同时减轻毒性的新策略。
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