Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Laboratory of Experimental Hematology-IIB, Institut Recerca Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Front Immunol. 2022 Jul 6;13:904497. doi: 10.3389/fimmu.2022.904497. eCollection 2022.
Immunotherapy with T cells genetically modified with chimeric antigen receptors (CARs) has shown significant clinical efficacy in patients with relapsed/refractory B-cell lymphoma. Nevertheless, more than 50% of treated patients do not benefit from such therapy due to either absence of response or further relapse. Elucidation of clinical and biological features that would predict clinical response to CART19 therapy is of paramount importance and eventually may allow for selection of those patients with greater chances of response. In the last 5 years, significant clinical experience has been obtained in the treatment of diffuse large B-cell lymphoma (DLBCL) patients with CAR19 T cells, and major advances have been made on the understanding of CART19 efficacy mechanisms. In this review, we discuss clinical and tumor features associated with response to CART19 in DLBCL patients as well as the impact of biological features of the infusion CART19 product on the clinical response. Prognosis of DLBCL patients that fail CART19 is poor and therapeutic approaches with new drugs are also discussed.
嵌合抗原受体 (CAR) 修饰的 T 细胞免疫疗法在复发/难治性 B 细胞淋巴瘤患者中显示出显著的临床疗效。然而，由于无反应或进一步复发，超过 50%的接受治疗的患者无法从中受益。阐明可预测 CART19 治疗临床反应的临床和生物学特征至关重要，最终可能允许选择那些具有更大反应机会的患者。在过去的 5 年中，在使用 CAR19 T 细胞治疗弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者方面获得了重要的临床经验，并在理解 CART19 疗效机制方面取得了重大进展。在这篇综述中，我们讨论了与 DLBCL 患者对 CART19 反应相关的临床和肿瘤特征，以及输注的 CART19 产品的生物学特征对临床反应的影响。失败的 DLBCL 患者的预后很差，也讨论了新药物的治疗方法。
