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提高嵌合抗原受体T细胞疗法治疗血液系统恶性肿瘤疗效的临床策略

Clinical Strategies for Enhancing the Efficacy of CAR T-Cell Therapy for Hematological Malignancies.

作者信息

Liu Qianzhen, Liu Zengping, Wan Rongxue, Huang Wenhua

机构信息

School of Basic Medical Sciences, Guangdong Medical University, Dongguan 523000, China.

Department of Pathology, The First People's Hospital of Foshan, Foshan 528000, China.

出版信息

Cancers (Basel). 2022 Sep 14;14(18):4452. doi: 10.3390/cancers14184452.

Abstract

Chimeric antigen receptor (CAR) T cells have been successfully used for hematological malignancies, especially for relapsed/refractory B-cell acute lymphoblastic leukemia and non-Hodgkin's lymphoma. Patients who have undergone conventional chemo-immunotherapy and have relapsed can achieve complete remission for several months with the infusion of CAR T-cells. However, side effects and short duration of response are still major barriers to further CAR T-cell therapy. To improve the efficacy, multiple targets, the discovery of new target antigens, and CAR T-cell optimization have been extensively studied. Nevertheless, the fact that the determination of the efficacy of CAR T-cell therapy is inseparable from the discussion of clinical application strategies has rarely been discussed. In this review, we will discuss some clinical application strategies, including lymphodepletion regimens, dosing strategies, combination treatment, and side effect management, which are closely related to augmenting and maximizing the efficacy of CAR T-cell therapy.

摘要

嵌合抗原受体(CAR)T细胞已成功应用于血液系统恶性肿瘤,尤其是复发/难治性B细胞急性淋巴细胞白血病和非霍奇金淋巴瘤。接受过传统化疗免疫疗法且复发的患者,通过输注CAR T细胞可实现数月的完全缓解。然而,副作用和反应持续时间短仍是进一步开展CAR T细胞治疗的主要障碍。为提高疗效,人们对多个靶点、新靶抗原的发现以及CAR T细胞的优化进行了广泛研究。尽管如此,CAR T细胞治疗疗效的确定与临床应用策略的讨论密不可分这一事实却很少被提及。在本综述中,我们将讨论一些临床应用策略,包括淋巴细胞清除方案、给药策略、联合治疗和副作用管理,这些策略与增强和最大化CAR T细胞治疗的疗效密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54cd/9496667/04930923dc57/cancers-14-04452-g001.jpg

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