在TP53突变的中枢神经系统淋巴瘤中使用CAR-T细胞疗法:克服高风险的遗传障碍
Danyang Li1, Rui Liu1, Zhonghua Fu1
1Department of Lymphoma and Myeloma Research Center, Beijing GoBroad Hospital, Beijing, China.
Frontiers in medicine
|January 29, 2026
概括
化学抗原受体T (CAR-T) 细胞疗法在中枢神经系统淋巴瘤 (CNSL) 中显示出有效性,即使在具有TP53突变的患者中也是如此. 具有TP53突变的非生殖中心B细胞样CNSL患者可能从CAR-T疗法中获益最多.
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:
- 中枢神经系统淋巴瘤 (CNSL) 是一种具有挑战性的治疗选择的侵袭性恶性瘤.
- 在CNSL中TP53突变是关键的预后因素.
- 化学抗原受体T (CAR-T) 细胞疗法是B细胞淋巴瘤的一种有前途的治疗方法.
研究的目的:
- 评估CAR-T细胞治疗在CNSL患者的疗效,特别是那些具有TP53突变的患者.
- 为了比较TP53突变型和野生型CNSL患者与CAR-T治疗之间的结果.
- 为了确定影响接受CAR-T治疗的CNSL患者生存的预后因素.
主要方法:
- 在2020年至2024年期间接受治疗的61名CNSL患者的回顾性队列研究.
- 在接受CAR-T治疗的具有和没有TP53突变的患者中,分析整体生存 (OS) 和无进展生存 (PFS).
- 基于细胞起源 (COO) 分类的子组分析.
主要成果:
- 在接受CAR-T治疗的43名患者中,有17人患有TP53突变.
- 接受CAR-T治疗的TP53突变CNSL患者 (TP53+) 的整体应答率 (ORR) 为64.5%,平均寿命为14.07个月.
- 接受CAR-T治疗的TP53-野生型CNSL患者 (TP53-) 的ORR为73.3%,平均寿命为33.47个月.
- 在TP53+ CNSL患者中,非-GCB分类与显著更长的OS相关 (p=0.003).
结论:
- 在具有TP53突变的CNSL患者中,CAR-T细胞疗法显示出有效性.
- 卡特-T细胞疗法的疗效与传统的CNSL治疗方法相提并论.
- 卡特-T疗法可能对非GCB来源细胞分类的TP53+ CNSL患者特别有益.
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