整合免疫疗法用于治疗多发性骨髓瘤
Lekha Mikkilineni1, Surbhi Sidana1
1Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Journal of the National Comprehensive Cancer Network : JNCCN
|December 11, 2023
概括
新的T细胞疗法,包括CAR T细胞疗法和双特异性抗体,为患有三级耐火性多发性髓瘤的患者提供了改善的结果. 了解最佳测序和管理毒性对于这些先进的治疗方法至关重要.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 复发性或耐药性多发性骨髓瘤 (RRMM) 耐药于标准疗法提出了重大挑战.
- 三级耐火性多发性髓瘤 (MM) 表示对蛋白酶体抑制剂,免疫调节药物 (IMiD) 和抗CD38抗体的耐药性.
- 这个患者群体的特点是有限的治疗选择和糟糕的结果.
研究的目的:
- 审查新型T细胞参与治疗三级耐火性多发性骨髓瘤的有效性和安全性.
- 突出批准和正在研究的CAR T细胞疗法和双特异性抗体 (BsAbs).
- 讨论当前的情况,包括目标,不良事件和未来的方向.
主要方法:
- 审查最近的临床数据和FDA批准的RRMM治疗方法,截至2023年9月.
- 对针对BCMA和GPRC5D的T细胞吸引疗法的分析.
- 综述常见和产品特异性不良反应,包括细胞因子释放综合征和神经毒性.
主要成果:
- 针对BCMA和GPRC5D的CAR T细胞疗法和BsAbs在重度预治疗的RRMM患者中显示出高响应率.
- 几种针对BCMA和GPRC5D的治疗方法已获得FDA批准,用于至少四种先前治疗线的患者.
- 试验性疗法正在显示出有希望的结果,正在探索早期使用.
结论:
- 参与T细胞的疗法在治疗三级耐火性多发性骨髓瘤方面取得了重大进展.
- 这些新型药物的最佳测序和毒性的主动管理对于最大限度地提高患者益处至关重要.
- 对新目标和早期治疗设置的持续研究有望进一步改善结果.
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