嵌合抗原受体T细胞免疫疗法后多发性骨髓瘤复发机制及应对策略的研究现状

Research status on mechanisms and coping strategies of relapse after chimeric antigen receptor T cell immunotherapy in multiple myeloma

多发性骨髓瘤(MM)是表现为浆细胞克隆性增殖的恶性血液肿瘤, 在经过多线治疗后多数患者最终进展为复发/难治性(R/R)MM。嵌合抗原受体T细胞(CAR-T)免疫疗法作为一种新兴的恶性肿瘤靶向疗法, 已在临床试验中取得了令人鼓舞的疗效, 但仍有MM患者在接受CAR-T免疫疗法后1年内复发。导致MM复发的确切机制仍不清楚, CAR-T自身因素、靶抗原丢失、肿瘤微环境等均可能参与其中。笔者拟对CAR-T免疫疗法后MM复发的潜在机制及相关应对策略的研究现状进行阐述, 旨在为CAR-T免疫疗法在MM中的应用提供参考。

Multiple myeloma(MM)is a hematological malignancy characterized by clonal proliferation of plasma cells.After multiline therapy,most patients eventually progressed to relapsed/refractory(R/R)MM.Chimeric antigen receptor T cell(CAR-T)immunotherapy,as a new targeted therapy for malignant tumors,despite the encouraging efficacy of CAR-T immunotherapy in clinical trials,but some MM patients still relapse within 1 year after CAR-T immunotherapy.Exact mechanisms leading to MM relapse are still unclear.CAR-T,target antigen loss,tumor microenvironment and other factors may be involved.This article reviews research status on potential mechanisms and related coping strategies of MM relapse after CAR-T immunotherapy,in order to provide reference for application of CAR-T immunotherapy in MM.