Epstein-Peterson Zachary D, Palomba M Lia
Lymphoma Service, Division of Hematologic Malignancies, New York, NY.
Cellular Therapy Service, Division of Hematologic Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY.
Hematology Am Soc Hematol Educ Program. 2024 Dec 6;2024(1):48-53. doi: 10.1182/hematology.2024000657.
While targeted therapies such as Bruton's tyrosine kinase and BCL2 inhibitors have fundamentally changed the treatment of mantle cell lymphoma (MCL), not all patients respond to these therapies, and responses are finite and can be fleeting, especially with high-risk MCL. As patients progress through successive therapies, the clinical course is characterized by shortening response times,1 frequent disease acceleration, and limited survival outcomes. Recently, the sensitivity of MCL to novel immune-based therapies is being realized with favorable results, as chimeric antigen receptor-modified T cells and bispecific T-cell-engaging antibodies are being investigated and implemented into practice for patients. However, critical issues remain to understand the role of these agents in routine practice. In this review, we discuss the current landscape regarding these agents, examine our approach to incorporating them into practice, and consider unanswered questions that we must ultimately address to improve outcomes for patients.
虽然布鲁顿酪氨酸激酶和BCL2抑制剂等靶向疗法从根本上改变了套细胞淋巴瘤(MCL)的治疗方式,但并非所有患者都对这些疗法有反应,而且反应是有限的,可能转瞬即逝,尤其是高危MCL患者。随着患者经历连续的治疗,临床病程的特点是缓解时间缩短、疾病频繁加速以及生存结果有限。最近,人们认识到MCL对新型免疫疗法敏感且效果良好,因为嵌合抗原受体修饰的T细胞和双特异性T细胞衔接抗体正在接受研究并应用于患者治疗。然而,在理解这些药物在常规治疗中的作用方面,关键问题仍然存在。在这篇综述中,我们讨论了关于这些药物的当前情况,审视了将它们纳入治疗的方法,并思考了为改善患者预后我们最终必须解决的未回答问题。