Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, W7, N15, Kita-Ku, Sapporo, Hokkaido, Japan.
Department of Hematology, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
Int J Hematol. 2024 Jul;120(1):6-14. doi: 10.1007/s12185-024-03792-2. Epub 2024 May 25.
Approximately 60-70% of patients with large B cell lymphoma (LBCL) achieve long-term remission or a cure after initial treatment. However, patients who relapse or are refractory to initial treatment have a poor prognosis. Chimeric antigen receptor (CAR) T cell therapy has recently attracted attention for its potential to provide a cure or long-term remission even for LBCL that has relapsed or is refractory to conventional chemotherapy. Currently, three CAR T cell products are clinically available for LBCL: tisagenlecleucel (tisa-cel), axicabtagene ciloleucel (axi-cel) and lisocabtagene maraleucel (liso-cel). These CAR T cell products were initially approved as third- or later-line therapies worldwide. Recently, axi-cel and liso-cel have become feasible as second-line therapies for patients with early relapsed or refractory disease after first-line chemotherapy. Although a large body of data on CAR T cell therapy has been accumulated, the clinical question of how to choose between these three available CAR T cell products has yet to be resolved. The appropriate approach to treatment selection for patients who relapse after CAR T cell therapy also remains unclear. This review discusses treatment strategies to maximize the benefits of CAR T cell therapy.
大约 60-70%的大 B 细胞淋巴瘤 (LBCL) 患者在初始治疗后可获得长期缓解或治愈。然而，对于那些复发或对初始治疗无反应的患者，预后较差。嵌合抗原受体 (CAR) T 细胞疗法最近因其为复发或对常规化疗无反应的 LBCL 提供治愈或长期缓解的潜力而受到关注。目前，有三种 CAR T 细胞产品可用于治疗 LBCL：tisagenlecleucel (tisa-cel)、axicabtagene ciloleucel (axi-cel) 和 lisocabtagene maraleucel (liso-cel)。这些 CAR T 细胞产品最初在全球范围内被批准为三线或三线以上的治疗方法。最近，axi-cel 和 liso-cel 已成为一线化疗后早期复发或难治性疾病患者的二线治疗方法。尽管已经积累了大量关于 CAR T 细胞疗法的数据，但如何在这三种可用的 CAR T 细胞产品之间进行选择的临床问题尚未得到解决。CAR T 细胞治疗后复发患者的治疗选择适当方法也尚不清楚。这篇综述讨论了最大限度地提高 CAR T 细胞疗法效益的治疗策略。
