Abstract:
Overall, around 40% of patients with diffuse large B-cell lymphoma (DLBCL) have refractory disease or relapse after the first line of treatment. Until relatively recently, the prognosis of patients with relapsed or refractory DLBCL was very poor and treatment options were very limited. In recent years, several novel therapies have been approved that provide more effective options than conventional chemotherapy and that have manageable toxicity profiles. CAR-T cell therapy has become the new standard treatment for patients with refractory or early relapsed DLBCL, based on the positive results of the phase 3 ZUMA-7 and TRANSFORM clinical trials. This review addresses the role of CAR-T therapy and autologous stem cell transplantation in the treatment of these patients and other approved options for patients who are not candidates for transplant, such as the combinations of polatuzumab vedotin with bendamustine and rituximab, and tafasitamab with lenalidomide.
摘要:
总的来说,约40%的弥漫性大B细胞淋巴瘤(DLBCL)患者在一线治疗后出现难治性疾病或复发.直到最近,复发或难治性DLBCL患者的预后非常差,治疗选择非常有限.近年来,已经批准了几种新疗法,它们提供了比常规化疗更有效的选择,并且具有可控的毒性.CAR-T细胞疗法已成为难治性或早期复发DLBCL患者的新标准治疗方法,基于3期ZUMA-7和TRANSFORM临床试验的阳性结果。这篇综述讨论了CAR-T疗法和自体干细胞移植在这些患者的治疗中的作用,以及其他不适合移植的患者的批准选择。例如polatuzumabvedotin与苯达莫司汀和利妥昔单抗的组合,和他法西他单抗联合来那度胺.