《嵌合抗原受体T细胞疗法的免疫相关不良事件管理:ASCO指南》解读  

Comments on^Management of immune-related adverse events in patients treated with chimeric antigen receptor T-cell therapy:ASCO guideline^

作　　者：肖希斌[1] 李萍[2] 梁爱斌[2] 钱文斌 Xiao Xibin;Li Ping;Liang Aibin;Qian Wenbin(Department of Hematology,the Second Affiliated Hospital,Zhejiang University,School of Medicine,Hangzhou 310009,China;Department of Hematology,Tongji Hospital ofTongji University,Shanghai 200333,China)

机构地区：[1]浙江大学医学院附属第二医院血液内科,浙江杭州310009 [2]同济大学附属同济医院血液科,上海200333

出　　处：《实用肿瘤杂志》2022年第1期1-7,共7页Journal of Practical Oncology

基　　金：国家自然科学基金(82170219)。

摘　　要：免疫疗法革新了多种癌症的治疗现状。嵌合抗原受体T细胞(chimeric antigen receptor T-cell,CAR-T)疗法在血液肿瘤包括白血病、淋巴瘤和多发性骨髓瘤等疾病的治疗中取得巨大成功。与传统化疗不同的是,CAR-T疗法有独特的不良反应包括细胞因子释放综合征和中枢神经毒性等。自2021年6月以来我国已经批准两款CD19为靶点的CAR-T细胞产品上市,用于治疗难治复发B细胞淋巴瘤;此外,我国有数百项CAR-T治疗血液肿瘤和实体瘤的临床试验正在开展。随着CAR-T疗法在肿瘤治疗中的应用和相关临床研究日益广泛,其不良反应管理的必要性和重要性日益凸显。美国临床肿瘤学会(American Society of Clinical Oncology,ASCO)于2021年11月推出了首部《嵌合抗原受体T细胞疗法的免疫相关不良事件管理:ASCO指南》。本文将结合临床实践对ASCO指南进行解读,以期为CAR-T疗法不良反应的管理带来更深入的理解。Immunotherapy has revolutionized the treatment of many types of cancer. Chimeric antigen receptor T-cell(CAR-T) therapy has achieved great success in the treatment of hematological tumors including leukemia, lymphoma and multiple myeloma. Unlike conventional chemotherapy, CAR-T therapy has unique adverse effects including cytokine release syndrome and central neurotoxicity. Since June 2021,China has approved two CD19-targeted CAR-T cell products for the treatment of refractory relapsed B-cell lymphoma. In addition, hundreds of clinical trials of CAR-T therapy for hematological and solid tumors are underway in China. With the increasingly extensive application and clinical research of CAR-T therapy in tumor treatment, the necessity and importance of adverse reaction management are becoming increasingly prominent. The American Society of Clinical Oncology(ASCO) launched its first "Management of immune-related adverse events in patients treated with chimeric antigen receptor T-cell therapy: ASCO guideline" in November 2021. For more understanding of the management of adverse events to CAR-T therapy, the ASCO guideline will be interpreted in combination with clinical practice in this paper.

关 键 词：ASCO指南 嵌合抗原受体T细胞 细胞因子风暴 免疫效应细胞相关神经毒性综合征 免疫相关不良反应 

分 类 号：R730.51[医药卫生—肿瘤]