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重新定义 r/r 大 B 细胞淋巴瘤的精准管理:新型抗体在寻找未来治疗策略方面挑战 CAR-T 和 BMT。

Redefining Precision Management of r/r Large B-Cell Lymphoma: Novel Antibodies Take on CART and BMT in the Quest for Future Treatment Strategies.

机构信息

King Faisal Specialist Hospital and Research Centre, Jeddah 21499, Saudi Arabia.

College of Medicine, Al-Faisal University, Riyadh 11533, Saudi Arabia.

出版信息

Cells. 2023 Jul 14;12(14):1858. doi: 10.3390/cells12141858.


DOI:10.3390/cells12141858
PMID:37508523
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10378108/
Abstract

The treatment paradigms for patients with relapsed large B-cell lymphoma are expanding. Chimeric antigen receptor technology (CAR-T) has revolutionized the management of these patients. Novel bispecific antibodies and antibody-drug conjugates, used as chemotherapy-free single agents or in combination with other novel therapeutics, have been quickly introduced into the real-world setting. With such a paradigm shift, patients have an improved chance of better outcomes with unpredictable complete remission rates. Additionally, the excellent tolerance of new antibodies targeting B-cell lymphomas is another motivation to broaden its use in relapsed and refractory patients. With the increasing number of approved therapy approaches, future research needs to focus on optimizing the sequence and developing new combination strategies for these antibodies, both among themselves and with other agents. Clinical, pathological, and genetic risk profiling can assist in identifying which patients are most likely to benefit from these costly therapeutic options. However, new combinations may lead to new side effects, which we must learn to deal with. This review provides a comprehensive overview of the current state of research on several innovative antibodies for the precision management of large B-cell lymphoma. It explores various treatment strategies, such as CAR-T vs. ASCT, naked antibodies, antibody-drug conjugates, bispecific antibodies, and bispecific T-cell engagers, as well as discussing the challenges and future perspectives of novel treatment strategies. We also delve into resistance mechanisms and factors that may affect decision making. Moreover, each section provides a detailed analysis of the available literature and ongoing clinical trials.

摘要

复发弥漫大 B 细胞淋巴瘤的治疗模式正在不断扩展。嵌合抗原受体技术(CAR-T)已经彻底改变了这类患者的治疗模式。新型双特异性抗体和抗体药物偶联物,作为无化疗的单一药物或与其他新型疗法联合应用,已迅速引入实际应用。随着这种治疗模式的转变,患者有机会获得更好的结果,完全缓解率不可预测。此外,新型靶向 B 细胞淋巴瘤的抗体具有极好的耐受性,这也是将其扩大应用于复发和难治性患者的另一个动机。随着越来越多的治疗方法获得批准,未来的研究需要集中优化这些抗体的应用顺序并开发新的联合策略,包括这些抗体之间以及与其他药物的联合策略。临床、病理和遗传风险分析有助于确定哪些患者最有可能从这些昂贵的治疗选择中获益。然而,新的联合用药可能会带来新的副作用,我们必须学会应对。本综述全面概述了几种用于精准治疗弥漫大 B 细胞淋巴瘤的创新抗体的研究现状。它探讨了各种治疗策略,如 CAR-T 与 ASCT、裸抗体、抗体药物偶联物、双特异性抗体和双特异性 T 细胞衔接器,并讨论了新型治疗策略的挑战和未来展望。我们还深入探讨了耐药机制以及可能影响决策的因素。此外,每个部分都对现有文献和正在进行的临床试验进行了详细分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7253/10378108/df442e83c0b6/cells-12-01858-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7253/10378108/d85b39df0988/cells-12-01858-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7253/10378108/df442e83c0b6/cells-12-01858-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7253/10378108/d85b39df0988/cells-12-01858-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7253/10378108/df442e83c0b6/cells-12-01858-g002.jpg

相似文献

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[5]
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[7]
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[10]
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引用本文的文献

[1]
Targets for CAR Therapy in Multiple Myeloma.

Int J Mol Sci. 2025-6-24

[2]
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[3]
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[4]
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[5]
Tumor Biology Hides Novel Therapeutic Approaches to Diffuse Large B-Cell Lymphoma: A Narrative Review.

Int J Mol Sci. 2024-10-23

本文引用的文献

[1]
Blinatumomab consolidation post-autologous stem cell transplantation in patients with diffuse large B-cell lymphoma.

Blood Adv. 2024-2-13

[2]
Glofitamab in relapsed/refractory diffuse large B-cell lymphoma: Real-world data.

Hematol Oncol. 2023-10

[3]
Pembrolizumab in relapsed or refractory primary mediastinal large B-cell lymphoma: final analysis of KEYNOTE-170.

Blood. 2023-7-13

[4]
Identification and Empiric Evaluation of New Inhibitors of the Multidrug Transporter P-Glycoprotein (ABCB1).

Int J Mol Sci. 2023-3-10

[5]
Novel pathophysiological insights into CAR-T cell associated neurotoxicity.

Front Neurol. 2023-3-8

[6]
Treatments for Relapsed-Refractory Diffuse Large B-cell Lymphoma: A Preliminary Evaluation of the Place in Therapy of Glofitamab, a Bispecific Monoclonal Antibody.

Cureus. 2022-12-31

[7]
Salvage Using Polatuzumab Vedotin Based Therapy in Relapsed Refractory Large B-Cell Lymphomas: Early Experience from a Real-World Middle-Income Setting Using Named-Patient Compassionate Access Program.

Indian J Hematol Blood Transfus. 2022-12-25

[8]
Glofitamab for Relapsed or Refractory Diffuse Large B-Cell Lymphoma.

N Engl J Med. 2022-12-15

[9]
Antibodies to watch in 2023.

MAbs. 2023

[10]
Polatuzumab vedotin, rituximab, and bendamustine combination in relapsed or refractory diffuse large B-cell lymphoma: a real-world data from Turkey.

Ann Hematol. 2023-1

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