Division of Hematology, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland.
Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Hematol Oncol. 2024 Jan;42(1):e3237. doi: 10.1002/hon.3237. Epub 2023 Nov 8.
About one third of patients with diffuse large B-cell lymphoma (DLBCL) have a relapsing/refractory (R/R) disease after first line chemo-immunotherapy, with particularly poor outcomes observed in patients with primary refractory disease and early relapse. CD19 specific chimeric antigen receptor (CAR) T cell therapy is a game changer that results in durable and complete response rates in almost half of the patients with R/R DLBCL. Other emerging CD19-targeting therapies include monoclonal antibodies, bispecific antibodies and targeting antibody-drug conjugates, which also show encouraging results. However, the timing and sequencing of different anti-CD19-targeting agents and how they might interfere with subsequent CAR T cell treatment is still unclear. In this review, we summarize the results of the pivotal clinical trials as well as evidence from real-world series of the use of different CD19-targeting approved agents. We discuss the effect of various therapies on CD19 expression and its implications for treatment sequencing.
大约三分之一的弥漫性大 B 细胞淋巴瘤（DLBCL）患者在一线化疗免疫治疗后出现复发/难治（R/R）疾病，原发性难治性疾病和早期复发的患者观察到的结局特别差。CD19 特异性嵌合抗原受体（CAR）T 细胞治疗是一个改变游戏规则的方法，几乎一半的 R/R DLBCL 患者可获得持久和完全缓解率。其他新兴的 CD19 靶向治疗包括单克隆抗体、双特异性抗体和靶向抗体药物偶联物，它们也显示出令人鼓舞的结果。然而，不同抗 CD19 靶向药物的时机和顺序以及它们如何可能干扰随后的 CAR T 细胞治疗仍不清楚。在这篇综述中，我们总结了关键临床试验的结果以及来自真实世界系列使用不同批准的 CD19 靶向药物的证据。我们讨论了各种疗法对 CD19 表达的影响及其对治疗顺序的影响。
