cd19靶向CAR - T细胞作为大b细胞淋巴瘤的第一种挽救性治疗:走向合理的途径

Peter Dreger, Paolo Corradini, John G Gribben, Bertram Glass, Mats Jerkeman, Marie Jose Kersten, Franck Morschhauser, Alberto Mussetti, Andreas Viardot, Pier Luigi Zinzani, Anna Sureda
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引用次数: 0

摘要

cd19靶向嵌合抗原受体(CAR) t细胞疗法被批准用于高风险大b细胞淋巴瘤(LBCL)的二线治疗,极大地影响了这种疾病的挽救算法,这种疗法可能有潜力改善复发或难治性LBCL的病程。在这篇综述中,我们为在LBCL的二线治疗中使用商业化cd19定向CAR - T细胞的合理管理方法提供了指导,解决了有关合格组织学的关键问题;年龄、合并症和肿瘤生物学限制;对极具攻击性的肿瘤行为的处理;保持和桥接疗法。该指南以结构化的方式制定,对于每个问题,包括临床问题的描述,证据的总结,实用管理方法的基本原理和建议。这些建议有助于确定复发或难治性LBCL患者的最佳管理,这些患者考虑接受二线CAR - t细胞治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CD19-directed CAR T cells as first salvage therapy for large B-cell lymphoma: towards a rational approach

The approval of CD19-directed chimeric antigen receptor (CAR) T-cell therapies for the second-line treatment of high-risk large B-cell lymphoma (LBCL) has greatly affected salvage algorithms for this condition, and such therapies could have the potential to improve the course of relapsed or refractory LBCL. In this Review, we provide guidance for a rational management approach to the use of commercial CD19-directed CAR T cells in the second-line treatment of LBCL, addressing crucial questions regarding eligible histologies; age, comorbidity, and tumour biology restrictions; the handling of very aggressive tumour behaviour; and holding and bridging therapies. The guidance was developed in a structured manner and, for each question, consists of a description of the clinical issue, a summary of the evidence, the rationale for a practical management approach, and recommendations. These recommendations could help to decide on the optimal management of patients with relapsed or refractory LBCL who are considered for second-line CAR T-cell treatment.

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