文章：

滤泡性淋巴瘤靶向治疗：迈向无化疗治疗策略

Targeted Therapy in Follicular Lymphoma: Towards a Chemotherapy-Free Approach

原文发布日期：8 September 2023

DOI: 10.3390/cancers15184483

类型: Article

开放获取: 是

英文摘要：

Background: The treatment of follicular lymphoma (FL) has previously centered on chemoimmunotherapy, which can be disadvantageous due to patient intolerance, cumulative toxicities, and disease refractoriness. Targeted therapies can produce deep responses and improve progression-free and overall survival with more tolerable adverse event profiles. Methods: We summarize the current literature and key clinical trials regarding targeted therapies in follicular lymphoma both in the front-line and in the relapsed-refractory setting. Results: Targeted therapies studied in FL include immune modulators, anti-CD20 antibodies, Bruton’s tyrosine kinase (BTK) inhibitors, enhancers of zeste homolog 2 (EZH2) inhibitors, phosphoinositide 3-kinase (PI3K) inhibitors, and B-cell lymphoma 2 (BCL-2) inhibitors. Chimeric antigen receptor (CAR-T) therapy and bispecific T-cell engager (BiTE) therapies also show promise in monotherapy and in combination with targeted therapies. These therapies exhibit high overall response rates and substantial progression-free survival and overall survival, even in high-risk patients or patients previously refractory to chemotherapy or rituximab. Adverse events vary substantially but are generally manageable and compare favorably to the cumulative toxicities of chemotherapy. Conclusion: Targeted therapies represent a paradigm shift in the treatment of FL. Further studies are needed to directly compare these targeted therapies and their combinations, as well as to investigate biomarkers predictive of response.

摘要翻译： 

背景：滤泡性淋巴瘤（FL）的治疗以往主要围绕化学免疫疗法展开，但该方法可能因患者不耐受、累积毒性及疾病难治性而存在不足。靶向治疗能够产生深度缓解，改善无进展生存期和总生存期，且不良事件谱更为可控。方法：本文综述了当前关于滤泡性淋巴瘤一线治疗及复发难治性治疗中靶向疗法的相关文献及关键临床试验。结果：在滤泡性淋巴瘤中研究的靶向疗法包括免疫调节剂、抗CD20抗体、布鲁顿酪氨酸激酶（BTK）抑制剂、zeste同源物2增强子（EZH2）抑制剂、磷酸肌醇3-激酶（PI3K）抑制剂以及B细胞淋巴瘤2（BCL-2）抑制剂。嵌合抗原受体T细胞（CAR-T）疗法和双特异性T细胞衔接器（BiTE）疗法在单药治疗及与靶向疗法联合应用中也展现出潜力。这些疗法即使在化疗或利妥昔单抗难治的高危患者中，也表现出较高的总缓解率、显著的无进展生存期和总生存期获益。不良事件表现各异，但总体可控，相较于化疗的累积毒性具有明显优势。结论：靶向治疗代表了滤泡性淋巴瘤治疗模式的转变。未来需要进一步研究以直接比较这些靶向疗法及其联合方案，并探索能够预测治疗反应的生物标志物。

原文链接：

Targeted Therapy in Follicular Lymphoma: Towards a Chemotherapy-Free Approach