Cell Enhancement and Technologies for Immunotherapy, Children's National Hospital, Washington, DC; Department of Pediatrics, George Washington University, Washington, DC.
Semin Hematol. 2023 Nov;60(5):329-337. doi: 10.1053/j.seminhematol.2023.11.007. Epub 2023 Dec 5.
Chimeric antigen receptor T (CAR-T) cell therapy is an effective treatment for relapsed or refractory diffuse large B cell lymphoma (DLBCL) with 3 CD19 targeting products now FDA-approved for this indication. However, up to 60% of patients ultimately progress or relapse following CAR-T cell therapy. Mechanisms of resistance to CAR-T cell therapy in patients with DLBCL are likely multifactorial and have yet to be fully elucidated. Determining patient, tumor and therapy-related factors that may predict an individual's response to CAR-T cell therapy requires ongoing analysis of data from clinical trials and real-world experience in this population. In this review we will discuss the factors identified to-date that may contribute to failure of CAR-T cell therapy in achieving durable remissions in patients with DLBCL.
嵌合抗原受体 T (CAR-T) 细胞疗法是一种有效的治疗方法，可用于治疗复发或难治性弥漫性大 B 细胞淋巴瘤 (DLBCL)，目前已有 3 种针对 CD19 的产品获得 FDA 批准用于该适应证。然而，多达 60%的患者在接受 CAR-T 细胞治疗后最终会出现进展或复发。DLBCL 患者对 CAR-T 细胞治疗产生耐药的机制可能是多因素的，目前尚未完全阐明。确定可能预测个体对 CAR-T 细胞治疗反应的患者、肿瘤和治疗相关因素，需要对该人群的临床试验数据和真实世界经验进行持续分析。在这篇综述中，我们将讨论迄今为止确定的可能导致 CAR-T 细胞治疗在实现 DLBCL 患者持久缓解方面失败的因素。
