弥漫大B细胞淋巴瘤的新型免疫药物治疗进展

Advances in the Management of Diffuse Large B-cell Lymphoma with Innovative Immunotherapeutic Agents

弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)是一种具有高度侵袭性和异质性的淋巴瘤,部分患者经传统化疗方案治疗后出现难治或复发。近年来新型免疫药物在DLBCL患者的治疗中取得较大进展,其中以单克隆抗体、抗体-药物偶联物(antibody-drug conjugate,ADC)、双特异性抗体(bispecific antibodies,BiTE)及免疫检查点抑制剂为代表的新型免疫药物可显著提高DLBCL患者的总生存率,为补救化疗无效或自体造血干细胞移植(autologous hematopoietic stem cell transplantation,auto-HSCT)后复发的患者提供更多选择。文章重点阐述近年来获批的新型免疫药物治疗DLBCL的作用机制,以及这些药物在临床试验中的效果与安全性。未来DLBCL的治疗策略将会是新型免疫药物联合其他药物的综合治疗,并有望在一线治疗中避开传统化疗药物,最大程度地提高患者的总生存率和生活质量。

Diffuse large B cell lymphoma(DLBCL)is a highly aggressive and heterogeneous lymphoma that is refractory or relapses in some patients treated with conventional chemotherapy regimens.In recent years,innovative immunotherapeutic agents have made great progress in the treatment of DLBCL patients,among which monoclonal antibodies,antibody-drug conjugate(ADC),bispecific antibodies(BiTE)and immune checkpoint inhibitors can significantly improve the overall survival rate of DLBCL patients and provide more options for patients who fail in chemotherapy or relapse after autologous hematopoietic stem cell transplantation(auto-HSCT).This article focuses on the mechanism underlying the treatment of DLBCL of immunotherapeutic agents approved in recent years,as well as the efficacy and safety of these drugs in clinical trials.In the future,the management of DLBCL will be a combination of immunotherapeutic and other agents,and is expected to avoid conventional chemotherapeutic drugs in the first-line treatment,maximizing the overall survival rate and quality of life of patients.