Kato Itaru
Department of Pediatrics, Graduate School of Medicine, Kyoto University.
Rinsho Ketsueki. 2024;65(7):662-667. doi: 10.11406/rinketsu.65.662.
Chimeric antigen receptor T-cell therapy (CAR-T-cell therapy) has revolutionized the treatment of relapsed and refractory hematological malignancies. Targeting of the CD19 antigen on B cells has yielded high rates of remission induction and sustained remission in patients with acute lymphoblastic leukemia and B-cell lymphomas. Despite these remarkable responses, many escape mechanisms from CAR-T cell therapy have been identified, with the most common being target antigen deficiency. This paper focuses on CD19 CAR-T cell therapies, which are currently the most clinically used, and describes new strategies to overcome resistance using multi-targeted CAR-T cells, such as CD19-CD20 CAR-T cells and CD19-CD22 CAR-T cells, which are being developed in preclinical and clinical trials.
嵌合抗原受体T细胞疗法（CAR-T细胞疗法）彻底改变了复发和难治性血液系统恶性肿瘤的治疗方式。针对B细胞上的CD19抗原进行治疗，已使急性淋巴细胞白血病和B细胞淋巴瘤患者获得了高缓解诱导率和持续缓解。尽管取得了这些显著疗效，但已发现许多CAR-T细胞疗法的逃逸机制，其中最常见的是靶抗原缺陷。本文重点关注目前临床上使用最广泛的CD19 CAR-T细胞疗法，并描述了使用多靶点CAR-T细胞（如正在临床前和临床试验中研发的CD19-CD20 CAR-T细胞和CD19-CD22 CAR-T细胞）克服耐药性的新策略。
