多发性骨髓瘤T细胞免疫治疗

T cell associated immunotherapy for multiple myeloma

多发性骨髓瘤(multiple myeloma,MM)是一种目前难以治愈的恶性浆细胞肿瘤,近年来蛋白酶体抑制剂和免疫调节剂的应用明显改善了治疗效果,但大部分MM患者最终难以逃脱复发的结局。越来越多的证据表明经体外活化或基因修饰的T细胞能在体内特异性的杀伤肿瘤细胞,有望治愈MM,尤其是近年来嵌合抗原受体修饰T细胞(chimeric antigen receptor-modified T cells,CAR-T)的发展,其能在体内以非MHC限制性方式特异杀伤表达特定抗原的肿瘤细胞,为MM的治疗提供了新的思路。本文将讨论T细胞免疫治疗的发展和技术改进,就目前较有前景的几种T细胞治疗方法做一综述。

Multiple myeloma（ MM） currently is an incurable plasma cell（ PC） malignancy. In recent decades,the introduction of proteasome inhibitor and the immunomodulatory drugs（ IMi Ds） has markedly improved the effect of myeloma therapy. However,most patients will still eventually suffer a fatal relapse after an initially effective therapy.Accumulating evidence suggests that adoptive transfer of ex vivo activated or genetic engineered T cells have a potent to specificly kill tumor cells and finally cure MM. Especially the development of chimeric antigen receptor- modified T cells（ CAR- T）,which could specifically kill tumor cells expressing related antigen in a non- MHC restricted way,provides a new strategy to treat MM. In this article we will discuss development and technological innovation of several T- cell based immunotherapies.