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嵌合抗原受体 T 细胞疗法治疗弥漫性大 B 细胞淋巴瘤和高级别 B 细胞淋巴瘤的最新进展。

Current development of chimeric antigen receptor T-cell therapy for diffuse large B-cell lymphoma and high-grade B-cell lymphoma.

机构信息

Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan.

出版信息

Eur J Haematol. 2024 May;112(5):662-677. doi: 10.1111/ejh.14166. Epub 2024 Jan 3.

Abstract

Chimeric antigen receptor (CAR) T-cell therapy has become a commercially available treatment option for relapsed or refractory (r/r) diffuse large B-cell lymphoma (DLBCL) with two or more lines of prior therapies, and recently for high-risk r/r DLBCL with one prior line of therapy. The successful development of CAR T-cell therapy for multiple relapsed DLBCL has led to a boom in subsequent trials that investigated its utility in patients with other r/r B-cell lymphoma subtypes. However, CAR T-cell therapy is a multistep process that includes leukapheresis and manipulation which take several weeks. Therefore, patients with rapidly progressing or bulky disease may not be able to complete the therapeutic regimen involving CAR T-cell products. This raises the question of the generalizability of the results of pivotal studies to the entire population. In this review, we summarize the development of CAR-T cell therapy for B-cell lymphoma and discuss strategies to further improve the clinical outcomes of this treatment.

摘要

嵌合抗原受体 (CAR) T 细胞疗法已成为二线或以上治疗方案失败的复发或难治性(r/r)弥漫性大 B 细胞淋巴瘤(DLBCL)的一种商业上可获得的治疗选择,最近也用于一线治疗方案失败的高危 r/r DLBCL。CAR T 细胞疗法在多种复发 DLBCL 中的成功开发导致随后的试验激增,这些试验研究了其在其他 r/r B 细胞淋巴瘤亚型患者中的应用。然而,CAR T 细胞疗法是一个多步骤的过程,包括需要数周时间的白细胞分离术和操作。因此,疾病进展迅速或肿块较大的患者可能无法完成涉及 CAR T 细胞产品的治疗方案。这就提出了一个问题,即关键研究的结果是否可以推广到整个人群。在这篇综述中,我们总结了 CAR-T 细胞疗法治疗 B 细胞淋巴瘤的发展,并讨论了进一步改善这种治疗临床效果的策略。

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