靶向BCMA CAR-T治疗RRMM的局限性及优化策略
Current Limitations and Potential Strategies of BCMA-targeted CAR-T Therapy in Relapsed Refractory Multiple Myeloma
刘汇洪 1王立茹2
作者信息
- 1. 首都医科大学第八临床医学院 北京 100038
- 2. 首都医科大学附属复兴医院血液内科 北京 100038
- 折叠
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.
Abstract
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.
关键词
B细胞成熟抗原/CAR-T疗法/复发难治性多发性骨髓瘤/耐药性Key words
B cell mature antigen/CAR-T therapy/Relapsed refractory multiple myeloma/Resistance引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据