在复发/阻断性地幔细胞淋巴瘤中T细胞重定向免疫疗法:当前证据,测序和未来方向
Santino Caserta1, Enrica Antonia Martino1, Ernesto Vigna1
1Department of Onco-Haematology, Haematology Unit, Cosenza, Italy.
European journal of haematology
|November 9, 2025
概括
化学抗原受体T细胞 (CAR-T) 疗法和双特异性抗体 (BsAbs) 为复发性/抗拒性地幔细胞淋巴瘤 (MCL) 提供了新的希望. 这些T细胞重定向免疫疗法提供了有效的治疗选择,个性化测序和组合改善了结果.
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:
- 复发/耐药的 (R/R) 斗细胞淋巴瘤 (MCL) 带来了重大治疗挑战,特别是在以前用布鲁顿的氨酸激酶抑制剂 (BTKis) 治疗的患者中.
- 转向T细胞的免疫疗法,包括嵌合式抗原受体T细胞 (CAR-T) 疗法和双特异性抗体 (BsAbs),已经成为转变性治疗选择.
研究的目的:
- 审查CAR-T疗法和BsAbs在R/R MCL中的情况.
- 讨论这些免疫疗法的疗效,局限性和潜在的测序策略.
主要方法:
- 对临床数据和关于CAR-T疗法 (例如,brexu-cel, liso-cel) 和BsAbs在R/RMCL中的临床数据和新兴证据的审查.
- 对治疗挑战,毒性 (细胞因子释放综合征,神经毒性) 和管理策略的分析.
主要成果:
- CAR-T疗法显示出高响应率和持久缓解,但受到后勤问题和严重毒性的限制.
- BsAbs提供了一个可访问的,门诊友好的选择,具有可控的毒性,在CAR-T先前和CAR-T后的患者中都表现出活性.
- 新出现的数据支持顺序或组合方法,例如BsAbs作为桥梁到CAR-T或反之,以及与其他代理商的组合.
结论:
- CAR-T和BsAbs是R/R MCL的互补,有效的模式.
- 个性化治疗序列和合理组合对于优化这种高风险患者群体的长期结果至关重要.
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