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迈出双重耐药性疾病的下一步:慢性淋巴细胞白血病的当前和未来治疗策略

Manabu Hayama¹, John C Riches¹

¹Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, UK.

OncoTargets and therapy

|March 13, 2024

概括

慢性淋巴细胞白血病 (CLL) 患者的新疗法正在出现,这些患者在布鲁顿氨酸激酶抑制剂 (BTKis) 和venetoclax治疗后复发. 其中包括新的BCR信号抑制剂和免疫疗法,为以前未经治疗的疾病提供希望.

科学领域:

血液学血液学血液学
在瘤学瘤学.
免疫学免疫学免疫学

背景情况:

慢性淋巴细胞白血病 (CLL) 是一种B细胞恶性瘤,由B细胞受体 (BCR) 信号和对亡的抵抗驱动.
协同布鲁顿氨酸激酶抑制剂 (cBTKis) 和venetoclax (BCL2抑制剂) 已经超过了CLL治疗的化疗免疫疗法.
尽管有进展,但CLL仍然无法治愈,患者在cBTKi和venetoclax疗法后复发,需要新的治疗策略.

研究的目的:

对复发性/耐药性 (RR) CLL 新型治疗剂的疗效进行审查.
探索以前接触过cBTKis和venetoclax的患者的新兴治疗方法.
讨论个性化和组合策略来管理耐治疗的CLL.

主要方法:

对比cBTKis和venetoclax与化疗免疫治疗的第三阶段试验的审查.
对RR-CLL中新型BCR信号抑制剂的早期临床试验数据的分析.
在重度预治疗的RR-CLL患者中评估免疫疗法 (双特异性抗体,CAR T细胞) 的抗瘤活性.

主要成果:

cBTKis和venetoclax在各种CLL环境中显示出比化疗免疫疗法更高的疗效.
在RR-CLL的早期试验中,新的BCR信号代理显示出有前途.
双特异性抗体和CAR T细胞在重度预处理的RR-CLL中表现出抗瘤活性.

结论:

目前的cBTKis和venetoclax等疗法没有治愈效果,耐药性需要进一步的治疗选择.
针对BCR信号和免疫治疗的新型药物为RR-CLL提供了有前途的途径.
个性化的方法和由抵抗机制告知的组合策略对于优化未来的CLL治疗至关重要.

关键词:

这是一种BCL2抑制剂.这是一种BTK抑制剂.在CAR-T细胞疗法中.在 CLL CLL 中.两种特异性抗体的抗体

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