二特异性抗体和CAR-T细胞:对抗大型B细胞淋巴瘤的免疫疗法
Asaad Trabolsi1,2, Artavazd Arumov1,3, Jonathan H Schatz4,5
1Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Fl, USA.
Blood cancer journal
|February 8, 2024
概括
化学抗原受体T细胞 (CAR-19) 疗法为30-40%的复发性/耐药性扩散性大B细胞淋巴瘤 (DLBCL) 患者提供治疗方法. 双特异性抗体 (BsAbs) 是一个新的选择,但长期治愈数据正在等待.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 血液学 血液学 血液学
背景情况:
- 扩散性大B细胞淋巴瘤 (DLBCL) 仍然具有挑战性,许多患者在初始治疗失败后需要救援疗法.
- 虽然标准治疗为复发性/耐药性 (rel/ref) DLBCL提供了有限的治愈率,但新型免疫疗法正在出现.
研究的目的:
- 为了比较CD19导向的仿真抗原受体T细胞 (CAR-19) 疗法和双特异抗体 (BsAbs) 在治疗复发性/耐药DLBCL中的疗效和挑战.
- 讨论这些免疫疗法在DLBCL治疗范式中的演变作用.
主要方法:
- 在rel/ref DLBCL.中对CAR-19疗法的长期随访数据的审查.
- 对DLBCL中双特异抗体 (BsAbs) 的最近批准和临床试验数据的分析.
- 与CAR-19和BsAbs之间免疫相关的副作用概况和后勤考虑的比较.
主要成果:
- 在30-40%的rel/refDLBCL患者中,包括高危人群中,CAR-19疗法显示出持久的,潜在的治愈结果.
- 双特异性抗体 (BsAbs) 是一种新的治疗方式,具有与CAR-19相似的疗效,但通常副作用较轻,物流障碍较少.
- BsAbs可以在社区环境中使用,与CAR-19不同,CAR-19需要专门的中心.
结论:
- 对于rel/refDLBCL来说,CAR-19疗法是首选的选择,尽管存在物流方面的挑战,但它提供了治愈的机会.
- BsAbs代表了重大进步,提供了一个新的治疗途径,可获得性得到改善,尽管仍在收集长期治疗数据.
- 未来的DLBCL治疗将越来越多地涉及效应细胞介导免疫疗法,需要进一步优化CAR-19和BsAb方法.
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