Miklos David B, Riedell Peter A, Bokun Alex, Chavez Julio C, Schuster Stephen J
Stanford University School of Medicine, Stanford, CA, USA.
David and Etta Jonas Center for Cellular Therapy, The University of Chicago, Chicago, IL, USA.
Target Oncol. 2025 Mar;20(2):217-234. doi: 10.1007/s11523-025-01133-9. Epub 2025 Mar 4.
Standard treatment options for B cell malignancies include immunochemotherapies and/or targeted therapies, which often provide temporary disease remission. However, many patients do not achieve complete remission with these treatments, develop resistance, and eventually experience disease relapse. New immunomodulatory treatments, such as T cell-based therapies, show promise in treating various types of blood cancers, including B cell malignancies. However, their effectiveness is often limited by the immunosuppressive tumor microenvironment and altered function of patient-derived T cells. Ibrutinib, a Bruton tyrosine kinase inhibitor, has been shown to restore immune balance and function in patients with chronic lymphocytic leukemia. Ibrutinib is being studied as adjuvant or combinatorial therapy with chimeric antigen receptor (CAR) T cells or T cell-engaging bispecific antibodies for the treatment of B cell malignancies. Current evidence suggests that ibrutinib could be beneficial when used before, during, or after CAR T cell administration, potentially providing higher complete response rates and reduced toxicity. In conclusion, existing evidence strongly supports the combined use of ibrutinib and T cell therapies. However, additional clinical trials are needed to further validate the effectiveness of this treatment strategy in patients with various B cell malignancies.
B细胞恶性肿瘤的标准治疗方案包括免疫化疗和/或靶向治疗,这些治疗通常能使疾病得到暂时缓解。然而,许多患者在接受这些治疗后并未实现完全缓解,产生耐药性,并最终出现疾病复发。新的免疫调节治疗方法,如基于T细胞的疗法,在治疗包括B细胞恶性肿瘤在内的各种类型血液癌症方面显示出前景。然而,它们的有效性常常受到免疫抑制性肿瘤微环境以及患者来源T细胞功能改变的限制。伊布替尼,一种布鲁顿酪氨酸激酶抑制剂,已被证明能恢复慢性淋巴细胞白血病患者的免疫平衡和功能。伊布替尼正在作为与嵌合抗原受体(CAR)T细胞或T细胞接合双特异性抗体的辅助或联合疗法进行研究,用于治疗B细胞恶性肿瘤。目前的证据表明,在CAR T细胞给药之前、期间或之后使用伊布替尼可能有益,有可能提供更高的完全缓解率并降低毒性。总之,现有证据有力地支持伊布替尼与T细胞疗法联合使用。然而,需要更多的临床试验来进一步验证这种治疗策略对各种B细胞恶性肿瘤患者的有效性。
Leuk Lymphoma. 2013-8-28
Leuk Lymphoma. 2018-12