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化学抗原受体T细胞和双特异性抗体治疗多发性骨髓瘤:向未来迈进

Sarah A Holstein¹, Shakira J Grant², Tanya M Wildes¹

¹Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

|July 20, 2023

概括

化学抗原受体 (CAR) T细胞和双特异性抗体 (BsAb) 疗法为患有耐火性疾病的多发性髓瘤 (MM) 患者提供了新的希望. 这些治疗方法显示出高响应率,改变了护理,但需要进一步研究以获得最佳使用和公平获取.

科学领域:

血液学血液学血液学
免疫治疗是一种免疫疗法.
在瘤学瘤学.

背景情况:

历史上,由于治疗选择有限,三类和五种药物耐药性多发性骨髓瘤 (MM) 的结果不佳.
仿真抗原受体 (CAR) T细胞和T细胞重定向双特异抗体 (BsAb) 疗法的出现显著改善了严重复发/耐药 (R/R) MM 患者的治疗结果.

研究的目的:

审查批准的B细胞成熟抗原 (BCMA) 导向的CAR T细胞疗法和R/R MM的BCMA/CD3 BsAbs的最新数据.
提供新兴CAR T细胞和BsAb疗法的概述,包括非BCMA向剂.
讨论有效性,安全性,最佳测序,支持性护理和公平获得这些新型MM疗法.

主要方法:

对R/RMM中已批准的CAR-T细胞和BsAb疗法的最新临床数据的审查.
对正在进行和正在发展的CAR T细胞和BsAb疗法的分析.
检查安全概况,包括细胞因子释放综合征,神经毒性和感染风险.
讨论治疗顺序,支持性护理和获取差异.

主要成果:

已批准的BCMA导向的CAR T细胞疗法 (idecabtagene vicleucel,ciltacabtagene autoleucel) 和BCMA/CD3 BsAb (teclistamab) 在晚期R/R MM中显示出前所未有的响应率.
新兴疗法,包括非BCMA向剂,正在开发中.
关键的安全问题包括细胞因子释放综合征,神经毒性和感染风险.

结论:

汽车T细胞和BsAb疗法正在改变R/RMM的治疗范式.
需要进一步的研究来优化这些新疗法的利用,包括测序和支持性护理.
解决挑战少数群体平等获取机会的因素至关重要.

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