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2020, Volume 14, Issue 6

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Frontiers of Medicine >> 2020, Volume 14, Issue 6 doi: 10.1007/s11684-020-0808-3

A giant step forward: chimeric antigen receptor T-cell therapy for lymphoma

. Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China;.. Zhejiang Province Engineering Laboratory for Stem Cell and Immunotherapy, Hangzhou 310000, China;.. Institute of Hematology, Zhejiang University, Hangzhou 310000, China;.. PET-CT Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China

Received: 2020-10-27 Accepted: 2020-11-26 Available online: 2020-11-26
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Abstract

The combination of the immunotherapy (i.e., the use of monoclonal antibodies) and the conventional chemotherapy increases the long-term survival of patients with lymphoma. However, for patients with relapsed or treatment-resistant lymphoma, a novel treatment approach is urgently needed. Chimeric antigen receptor T (CAR-T) cells were introduced as a treatment for these patients. Based on recent clinical data, approximately 50% of patients with relapsed or refractory B-cell lymphoma achieved complete remission after receiving the CD19 CAR-T cell therapy. Moreover, clinical data revealed that some patients remained in remission for more than two years after the CAR-T cell therapy. Other than the CD19-targeted CAR-T, the novel target antigens, such as CD20, CD22, CD30, and CD37, which were greatly expressed on lymphoma cells, were studied under preclinical and clinical evaluations for use in the treatment of lymphoma. Nonetheless, the CAR-T therapy was usually associated with potentially lethal adverse effects, such as the cytokine release syndrome and the neurotoxicity. Therefore, optimizing the structure of CAR, creating new drugs, and combining CAR-T cell therapy with stem cell transplantation are potential solutions to increase the effectiveness of treatment and reduce the toxicity in patients with lymphoma after the CAR-T cell therapy.

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