Abdulhaq Haifaa, Hwang Andrew, Mahmood Omar
Division of Hematology/Oncology, University of California San Francisco, Fresno, CA, USA.
Onco Targets Ther. 2023 Jul 20;16:617-629. doi: 10.2147/OTT.S372783. eCollection 2023.
The outcomes of Relapsed/Refractory (R/R) Diffuse Large B-cell lymphoma have been historically poor. The recent development of several novel therapies including CD19 directed agents has improved the prognosis of this disease significantly. Chimeric antigen receptor (CAR) T-cell therapy has drastically changed the treatment of R/R DLBCL, but it is still associated with significant barriers and limited access. Tafasitamab (an anti-CD19 engineered monoclonal antibody), in addition to lenalidomide, has shown significant efficacy with exceptionally durable responses in patients with R/R DLBCL who are ineligible for autologous stem cell transplantation (ASCT). Tafasitamab-lenalidomide and certain other therapies (ie, antibody-drug conjugates and bispecific antibodies) are important treatment options for patients who are ineligible for CAR-T due to co-morbidities or lack of access, and patients with rapid progression of disease who are unable to wait for manufacturing of CAR-T. This review will thus discuss currently approved and recently studied targeted treatment options for patients with R/R DLBCL with an emphasis on CAR-T alternative options, particularly Tafasitamab-lenalidomide.
复发/难治性(R/R)弥漫性大B细胞淋巴瘤的预后历来较差。包括CD19导向药物在内的几种新型疗法的近期发展显著改善了这种疾病的预后。嵌合抗原受体(CAR)T细胞疗法彻底改变了R/R弥漫性大B细胞淋巴瘤的治疗方式,但它仍存在重大障碍且可及性有限。除来那度胺外,塔法西他单抗(一种抗CD19工程单克隆抗体)在不符合自体干细胞移植(ASCT)条件的R/R弥漫性大B细胞淋巴瘤患者中显示出显著疗效,且缓解持久。对于因合并症或无法获得CAR-T而不符合CAR-T治疗条件的患者,以及疾病进展迅速无法等待CAR-T制备的患者,塔法西他单抗-来那度胺和某些其他疗法(如抗体药物偶联物和双特异性抗体)是重要的治疗选择。因此,本综述将讨论目前已获批和近期研究的R/R弥漫性大B细胞淋巴瘤患者的靶向治疗选择,重点是CAR-T替代方案,尤其是塔法西他单抗-来那度胺。
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