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T细胞淋巴瘤:是时候有所发现并推进治疗了。

T cell lymphoma: time to make discoveries and advance treatment.

作者信息

Ishitsuka Kenji

机构信息

Department of Hematology and Rheumatology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.

出版信息

Int J Hematol. 2023 Apr;117(4):473-474. doi: 10.1007/s12185-023-03573-3. Epub 2023 Mar 14.

Abstract

T-cell lymphomas are rare and aggressive tumors, and not only basic research but also the establishment of standard therapies and development of novel drugs for these tumors once lagged behind those for B-cell lymphomas. Now, times have changed. Recent progress in genome-wide analysis made it possible to elucidate the molecular pathophysiology of T-cell lymphomas, and will further facilitate the development of individualized treatment. Japan has a terrible form of virally induced T-cell lymphoma known as adult T-cell leukemia/lymphoma (ATL). Japanese researchers have played significant roles in both basic and clinical research, and finally successfully introduced two brand new drugs from Japan, an anti-CCR4 antibody and an EZH1/2 inhibitor. Large phase 3 trials have now established the addition of brentuximab vedotin to conventional chemotherapy as the standard of care for CD30-positive peripheral T-cell lymphoma (PTCL), including ATL. In contrast, most novel drugs for relapsed/refractory PTCL have been approved on the basis of evidence from small phase 2 trials. Patients still have many unmet needs that we must address. This issue of Progress in Hematology focuses on progress in basic and clinical research on PTCL and ATL.

摘要

T细胞淋巴瘤是罕见的侵袭性肿瘤,过去不仅基础研究,而且针对这些肿瘤的标准疗法的建立和新药研发都曾落后于B细胞淋巴瘤。如今,情况已有所改变。全基因组分析的最新进展使得阐明T细胞淋巴瘤的分子病理生理学成为可能,并将进一步推动个体化治疗的发展。日本有一种由病毒诱发的恶性T细胞淋巴瘤,即成人T细胞白血病/淋巴瘤(ATL)。日本研究人员在基础研究和临床研究中都发挥了重要作用,最终成功从日本引入了两种全新药物,一种抗CCR4抗体和一种EZH1/2抑制剂。大型3期试验现已确定,在传统化疗基础上加用维布妥昔单抗作为包括ATL在内的CD30阳性外周T细胞淋巴瘤(PTCL)的标准治疗方案。相比之下,大多数用于复发/难治性PTCL的新药是基于小型2期试验的证据获批的。患者仍有许多未满足的需求有待我们去解决。本期《血液学进展》重点关注PTCL和ATL基础研究和临床研究的进展。

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