CAR-T治疗多发性骨髓瘤的耐药机制研究进展  

Research progress on mechanisms of drug resistance to CAR-T cell therapy in multiple myeloma

作　　者：高思妤 崔倩倩(综述) 马艳萍(审校)[2] Siyu Gao;Qianqian Cui;Yanping Ma(Shanxi Medical University,Taiyuan 030001,China;Department of Hematology,Second Hospital of Shanxi Medical University,Taiy-uan 030001,China)

机构地区：[1]山西医科大学,太原市030001 [2]山西医科大学第二医院血液科

出　　处：《中国肿瘤临床》2024年第22期1170-1174,共5页Chinese Journal of Clinical Oncology

摘　　要：多发性骨髓瘤(multiple myeloma,MM)是一种浆细胞恶性肿瘤,主要表现为骨痛、肾功能不全、高钙血症、贫血和反复感染。随着蛋白酶体抑制剂(proteasome inhibitors,PIs)、免疫调节剂(immunomodulatory drugs,IMiDs)、单克隆抗体、嵌合抗原受体T细胞疗法(chimeric antigen receptor T-cell immunotherapy,CAR-T)和新药物的研发,MM患者的生存和预后发生了里程碑式的改变,但仍无法治愈。CAR-T细胞可以特异性地靶向并杀死带有特定抗原的MM细胞,已成为复发难治性多发性骨髓瘤(relapsed/refractory MM,R/R MM)的一种有希望的治疗方法,尽管治疗进展显著,但几乎所有MM患者均不可避免地因耐药而复发。本文就CAR-T治疗MM的耐药机制及优化策略做一综述。Multiple myeloma(MM)is a plasma cell malignancy characterized by bone pain,renal insufficiency,hypercalcemia,anemia,and recurrent infections.The advent of proteasome inhibitors(PIs),immunomodulatory drugs(IMiDs),monoclonal antibodies,chimeric antigen receptor T-cell immunotherapy(CAR-T),and other novel drugs has significantly improved the survival and prognosis of patients with MM.However,a definitive cure remains elusive.CAR-T cell therapy offers a promising approach for relapsed and refractory MM by specifically targeting and eliminating MM cells through antigen recognition.Despite significant advancements in treatment,nearly all MM patients eventually relapse due to drug resistance.This article reviews the mechanisms of resistance and strategies to optimize CAR-T cell therapy for MM.

关 键 词：多发性骨髓瘤 嵌合抗原受体T细胞 耐药 免疫逃逸 肿瘤微环境 

分 类 号：R733.3[医药卫生—肿瘤]