Treatment strategies for relapse after CAR T-cell therapy in B cell lymphoma.
Treatment strategies for relapse after CAR T-cell therapy in B cell lymphoma.
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DOI：
10.3389/fped.2023.1305657
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发表时间：
2023
影响因子：
2.6
通讯作者：
中科院分区：
文献类型：
--
作者：
抗CD 19嵌合抗原受体T（CART 19）细胞疗法的临床试验显示，复发性/难治性B细胞恶性肿瘤患者的总体缓解率较高。CART 19细胞疗法已被美国食品和药物管理局批准用于初始治疗后不到12个月复发或一线治疗难治的患者。然而，CART 19细胞疗法仍然缺乏持久的缓解，30%-60%的患者在CART 19输注后最终会复发。一般来说，CART 19细胞治疗后复发的患者预后较差，并且已经广泛研究了治疗该患者群体的各种策略。CART 19失败可以通过CD 19阳性或CD 19阴性淋巴瘤细胞的出现来广泛分类。如果CD 19表达在淋巴瘤细胞上保留，则可以考虑第二次输注CART 19细胞或用免疫检查点抑制剂重新激活先前输注的CART 19细胞。当患者发生CD 19阴性复发时，靶向不同的抗原（例如，CD 20或CD 22）与CAR T细胞、研究性化疗或造血干细胞移植是潜在的治疗选择。然而，CART 19细胞治疗后复发性大B细胞淋巴瘤的挽救治疗尚未得到充分探索，并根据临床医生的个案决定进行。在这篇综述中，我们将重点关注迄今为止报道的挽救治疗，并讨论CART 19细胞治疗后复发/难治性大B细胞淋巴瘤的管理。
Clinical trials of anti-CD19 chimeric antigen receptor T (CART19) cell therapy have shown high overall response rates in patients with relapsed/refractory B-cell malignancies. CART19 cell therapy has been approved by the US Food and Drug Administration for patients who relapsed less than 12 months after initial therapy or who are refractory to first-line therapy. However, durable remission of CART19 cell therapy is still lacking, and 30%–60% of patients will eventually relapse after CART19 infusion. In general, the prognosis of patients who relapse after CART19 cell therapy is poor, and various strategies to treat this patient population have been investigated extensively. CART19 failures can be broadly categorized by the emergence of either CD19-positive or CD19-negative lymphoma cells. If CD19 expression is preserved on the lymphoma cells, a second infusion of CART19 cells or reactivation of previously infused CART19 cells with immune checkpoint inhibitors can be considered. When patients develop CD19-negative relapse, targeting different antigens (e.g., CD20 or CD22) with CAR T cells, investigational chemotherapies, or hematopoietic stem cell transplantation are potential treatment options. However, salvage therapies for relapsed large B-cell lymphoma after CART19 cell therapy have not been fully explored and are conducted based on clinicians' case-by-case decisions. In this review, we will focus on salvage therapies reported to date and discuss the management of relapsed/refractory large B-cell lymphomas after CART19 cell therapy.
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影响因子：
0.7
作者：
Kase AM;Kharfan-Dabaja MA;Donaldson A;Elliott J;Sher T
通讯作者：
Sher T
影响因子：
82.9
作者：
Deng Q;Han G;Puebla-Osorio N;Ma MCJ;Strati P;Chasen B;Dai E;Dang M;Jain N;Yang H;Wang Y;Zhang S;Wang R;Chen R;Showell J;Ghosh S;Patchva S;Zhang Q;Sun R;Hagemeister F;Fayad L;Samaniego F;Lee HC;Nastoupil LJ;Fowler N;Eric Davis R;Westin J;Neelapu SS;Wang L;Green MR
通讯作者：
Green MR
影响因子：
7.3
作者：
Zhu, Weiguo;Tao, Shi;Miao, Wenchun;Liu, Hui;Yuan, Xianggui
通讯作者：
Yuan, Xianggui
影响因子：
7.5
作者：
Dreger, Peter;Sureda, Anna;Hamadani, Mehdi
通讯作者：
Hamadani, Mehdi
影响因子：
11.4
作者：
Corradini, P.;Dodero, A.;Tarella, C.
通讯作者：
Tarella, C.