摘要
嵌合抗原受体T细胞(CAR-T)免疫疗法快速发展,为多发性骨髓瘤(MM)治疗带来新的曙光,尤其B细胞成熟抗原(BCMA)作为迄今为止最成功的靶标,靶向BCMA CAR-T疗法可以使MM的症状获得持久且深度的缓解,在复发难治性多发性骨髓瘤(RRMM)治疗中取得突破性进展。但由于抗原逃逸、CAR-T衰竭等因素,多数患者仍会进展或复发,靶向BCMA CAR-T治疗后复发或难治患者的后续治疗缺乏标准方案。同时,复杂、昂贵且耗时的个性化CAR-T制造流程也限制其临床疗效的发挥。针对此现状,该综述总结了靶向BCMA CAR-T治疗的局限性及其机制,同时结合MM治疗领域新进展,提出改善进展或RRMM患者结局的潜在优化治疗策略。
The rapid development of chimeric antigen receptor T cell(CAR-T)immunotherapy has brought new light to the treatment of multiple myeloma(MM),among which B cell mature antigen is one of the most popular and successful target.BCMA-targeted CAR-T therapy has demonstrated deep and durable remissions of myeloma symptoms,a breakthrough in the treatment of relapsed refractory multiple myeloma(RRMM).However,due to antigen escape,CAR-T failure and other factors,most patients will still progress or relapse,and there is a lack of standard follow-up therapies for RRMM patients after BCMA-targeted CAR-T therapy.Furthermore,the complex,expensive and time-consuming manufacturing process of personalized CAR-T also limits its clinical efficacy and application.In view of the above challenges,this review summarizes the limitations and mechanisms of BCMA-targeted CAR-T therapy,combined with the latest advances in the field of MM therapy,and proposes potential optimal treatment strategies to further improve progression or outcomes in RRMM patients.
作者
刘汇洪
王立茹
LIU Huihong;WANG Liru(The Eighth Clinical Medical College of Capital Medical University,Beijing 100038,China)
出处
《中国医学创新》
CAS
2024年第15期183-188,共6页
Medical Innovation of China
