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初级中枢神经系统淋巴瘤的最新进展和挑战:叙述性回顾
Le Ma1, Qiang Gong1
1Department of Hematology, Southwest Hospital, First Affiliated Hospital of the Army Medical University, Chongqing, China.
Translational cancer research
|June 12, 2023
概括
主要中枢神经系统淋巴瘤 (PCNSL) 是一种罕见的,激进的脑癌. 新的诊断工具和治疗方法,如PD-1阻断和CAR-T细胞疗法,为PCNSL患者的更好的结果提供了希望.
科学领域:
- 在瘤学瘤学.
- 神经学 神经学
- 血液学 血液学 血液学
背景情况:
- 初级中枢神经系统淋巴瘤 (PCNSL) 是一种罕见的,侵袭性的非霍奇金淋巴瘤.
- 由于缺乏特异性,诊断具有挑战性,导致高误诊率.
- 传统治疗提供有限的缓解时间和高复发率,具有显著的神经毒性.
研究的目的:
- 提供PCNSL诊断和治疗当前观点的概述.
- 审查和总结PCNSL潜在临床试验中的发现.
- 突出管理PCNSL的挑战和未来研究方向.
主要方法:
- 在PubMed (1991-2022) 的文献搜索中使用"初级中枢神经系统淋巴瘤"和"临床试验".
- 美国临床瘤学会和国家综合癌症网络指南的审查.
- 收录了126篇以英语,德语和法语出版的符合条件的文章.
主要成果:
- 使用流细胞计和细胞学提高了PCNSL的诊断准确性.
- 介质素10和化学因子C-X-C动机连接体13被确定为有前途的生物标志物.
- 编程死亡-1 (PD-1) 阻断和CAR-T细胞疗法显示出潜在的疗效,需要进一步的临床试验.
结论:
- 尽管治疗取得了进展,但PCNSL复发和低长期存活率仍然是一个重大挑战.
- 未来的研究重点是针对性药物 (ibrutinib,lenalidomide,PD-1抑制剂) 与传统疗法相结合.
- 通过CAR-T疗法和对PCNSL分子生物学的更好理解,有可能改善患者的预后.
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