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特法西单抗治疗难治/复发弥漫性大 B 细胞淋巴瘤。

Tafasitamab for refractory/relapsed diffuse large B-cell lymphoma.

机构信息

Department of Hematology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.

Department of Hematology, Foresea Life Insurance Guangzhou General Hospital, Guangzhou, China.

出版信息

Drugs Today (Barc). 2021 Sep;57(9):571-580. doi: 10.1358/dot.2021.57.9.3306767.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is a common lymphoproliferative and invasive disease. The current first-line regimen for the treatment of DLBCL is R-CHOP, which is the combination of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone. R-CHOP has significantly improved the outcome of DLBCL in the last decades. However, 30-40% of patients fail the therapy with R-CHOP. Salvage chemotherapy for relapsed/refractory DLBCL (R/R DLBCL) is extremely challenging, especially in elderly patients. In July 2020, a new monoclonal antibody, tafasitamab, was approved by the Food and Drug Administration (FDA) of the United States for the treatment of DLBCL. Tafasitamab is an anti-CD19 monoclonal antibody which is Fc-enhanced and humanized. CD19 is typically expressed in the developing B cells in non-Hodgkin's lymphomas. Tafasitamab has been proven to be a safe and valid treatment and recommended to be used in combination with lenalidomide in adults with R/R DLBCL who are ineligible for autologous stem cell transplantation (ASCT). This article evaluates the pharmacodynamics, pharmacokinetics, mechanism of action and the clinical application of tafasitamab in the treatment of DLBCL, particularly in R/R DLBCL. The advantages and disadvantages of using tafasitamab and chimeric antigen receptor T cells (CAR-T cells) targeting CD19 are also discussed.

摘要

弥漫性大 B 细胞淋巴瘤(DLBCL)是一种常见的淋巴增生性和侵袭性疾病。目前,DLBCL 的一线治疗方案是 R-CHOP,即利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松的联合方案。在过去几十年中,R-CHOP 显著改善了 DLBCL 的预后。然而,仍有 30-40%的患者对 R-CHOP 治疗无效。挽救性化疗对于复发/难治性弥漫大 B 细胞淋巴瘤(R/R DLBCL)是极具挑战性的,尤其是对于老年患者。2020 年 7 月,一种新的单克隆抗体——塔法昔单抗,被美国食品药品监督管理局(FDA)批准用于治疗 DLBCL。塔法昔单抗是一种抗 CD19 的单克隆抗体,具有增强的 Fc 区和人源化结构。CD19 通常在非霍奇金淋巴瘤中发育中的 B 细胞中表达。塔法昔单抗已被证明是一种安全有效的治疗方法,并被推荐与来那度胺联合用于不适合自体干细胞移植(ASCT)的 R/R DLBCL 成年患者。本文评估了塔法昔单抗在治疗 DLBCL 中的药效学、药代动力学、作用机制和临床应用,特别是在 R/R DLBCL 中的应用。还讨论了使用塔法昔单抗和嵌合抗原受体 T 细胞(CAR-T 细胞)靶向 CD19 的优缺点。

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