在复发性耐火原发性中枢神经系统淋巴瘤的新希望
Teresa Calimeri1, Carolina Steidl1, Paolo Fiore1,2
1Lymphoma Unit, IRCCS San Raffaele Scientific Institute.
Current opinion in oncology
|August 8, 2023
概括
复发性/难治性中枢神经系统原发性淋巴瘤 (rrPCNSL) 患者的预后不佳. 新兴的疗法,如BTK抑制剂和CAR-T细胞显示出希望,但需要进一步的研究,以改善这种具有挑战性的条件的结果.
科学领域:
- 神经瘤学神经瘤学
- 血液学 血液学 血液学
- 临床试验 临床试验
背景情况:
- 初级中枢神经系统淋巴瘤 (PCNSL) 治疗已取得进展,但复发/耐药病例 (rrPCNSL) 仍然是一个重大的临床挑战,生存率较低.
- 目前针对新诊断的PCNSL的策略在约50%的患者中实现了治愈,这使得对有效的rrPCNSL治疗的关键需求尚未得到满足.
- 诸如晚期复发和高剂量化疗与自身干细胞移植 (HDT-ASCT) 等因素会影响 rrPCNSL 的结果.
研究的目的:
- 审查复发性/耐药性初级中枢神经系统淋巴瘤 (rrPCNSL) 的当前治疗环境.
- 探索新兴的治疗策略和管理这种难以治疗的恶性瘤的未来方向.
- 突出 rrPCNSL 未满足的临床需求和推进研究的重要性.
主要方法:
- 在rrPCNSL.最近的研究和临床试验的文献综述.
- 分析不断发展的治疗模式,包括新药类和细胞疗法.
- 讨论影响rrPCNSL患者结局的因素.
主要成果:
- 尽管PCNSL治疗得到了改善,但 rrPCNSL患者的预后很糟糕,平均存活时间为6.8个月,总体5年存活率为18%.
- 新型疗法包括布鲁顿氨酸激酶抑制剂 (BTK-is),免疫调节药物 (IMiDs),免疫检查点阻断剂 (ICBs) 和CAR-T细胞正在研究中.
- 虽然一些新的方法显示初始响应率很高,但治疗持续时间通常很短,导致长期结果不令人满意.
结论:
- 对 rrPCNSL 的治疗是复杂的,缺乏标准的护理.
- 对PCNSL分子特征的持续研究对于开发更有效的疗法至关重要.
- 多学科合作对于改善 rrPCNSL 患者的治疗结果至关重要.
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