嵌合抗原受体
医学
细胞因子释放综合征
多发性骨髓瘤
不利影响
人口
蛋白酶体抑制剂
单克隆抗体
免疫学
肿瘤科
免疫疗法
内科学
抗体
免疫系统
环境卫生
作者
Norah Sadek,Bruno Almeida Costa,Karthik Nath,Sham Mailankody
摘要
The emergence of chimeric antigen receptor (CAR) T‐cell therapy has revolutionized the treatment of hematologic malignancies, including multiple myeloma (MM). Two BCMA‐directed CAR T‐cell products — idecabtagene vicleucel (ide‐cel) and ciltacabtagene autoleucel (cilta‐cel) — have received US Food and Drug Administration (FDA) approval for patients with relapsed/refractory MM who underwent four or more prior lines of therapy (including an immunomodulatory agent, a proteasome inhibitor, and an anti‐CD38 monoclonal antibody). Despite producing unprecedented response rates in an otherwise difficult to treat patient population, CAR T‐cell therapies are commonly associated with immune‐related adverse events (e.g., cytokine release syndrome and neurotoxicity), cytopenias, and infections. Moreover, many patients continue to exhibit relapse post‐treatment, with resistance mechanisms yet to be fully understood. Ongoing basic, translational, and clinical research efforts are poised to generate deeper insights into the optimal utilization of these therapies, improve their efficacy, minimize associated toxicity, and identify new target antigens in patients with MM.
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