CAR-T细胞治疗B细胞淋巴瘤存在的问题及应对策略

Problems and Coping Strategies of CAR T-Cell Therapy in B-Cell Lymphoma

嵌合抗原受体(CAR)是一种结合了抗原识别区域和T细胞活化区域的融合蛋白。嵌合抗原受体T细胞(CAR-T细胞)可以识别并杀死靶细胞,在治疗B细胞恶性肿瘤中获得了令人瞩目的疗效。目前已有两个自体CAR-T细胞产品(诺华公司的KYMRIAH和凯特公司的YESCARTA)通过美国食品药品监督管理局(FDA)审批上市,用于治疗儿童和青年复发难治性急性淋巴细胞白血病及复发难治性成人大B细胞性淋巴瘤。多项临床试验证实,CAR-T细胞治疗对化疗耐药/复发的B细胞淋巴瘤患者有显著疗效。文章对CAR-T细胞疗法在B细胞淋巴瘤上存在的问题及应对策略作一综述。

Chimeric antigen receptor(CAR)is a fusion protein that combines an antigen recognition region and a T cell activation region.Chimeric antigen receptor T cells(CAR-T cells),which can recognize and kill target cells,have achieved impressive efficacy in the treatment of B-cell malignancies.Two autologous CAR-T cell products(KYMRIAH from Novartis and YESCARTA from Kite)are currently available for marketing under the U S Food and Drug Administration(FDA)approval for the treatment of children and young adults with relapsed refractory acute lymphoblastic leukemia and relapsed refractory adult B-cell lymphoma.Multiple clinical trials have confirmed the remarkable efficacy of CAR-T cell therapy in chemoresistant/relapsed B-cell lymphoma patients.In this review,the authors reviewed the problems and coping strategies of CAR-T cell therapy in B-cell lymphoma.