CAR T-клеточная терапия множественной миеломы по материалам конгрессов ASH-2021 и ASCO-2022
ISSN (print) 1997-6933     ISSN (online) 2500-2139
2023-1
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Ключевые слова

CAR T-клеточная терапия
множественная миелома
химерный антигенный рецептор
антиген созревания В-клеток

Как цитировать

1.
Семочкин С.В. CAR T-клеточная терапия множественной миеломы по материалам конгрессов ASH-2021 и ASCO-2022. Клиническая онкогематология. 2024;16(1):1-13. doi:10.21320/2500-2139-2023-16-1-1-13

Ключевые слова

Аннотация

Современное лечение множественной миеломы (ММ), основанное на применении ингибиторов протеасом, иммуномодулирующих препаратов и моноклональных антител, в определенной степени достигло предела своих возможностей. Несмотря на значительный клинический прогресс, ММ по-прежнему относится к категории хронических неизлечимых заболеваний. Терапия опухоль-специфическими Т-клетками с химерным антигенным рецептором (CAR) представляет собой новый эволюционный шаг, направленный к излечению ММ. В качестве основной мишени CAR T-клеточной терапии ММ в настоящее время рассматривается антиген созревания В-клеток (BCMA). Данный рецептор в основном экспрессируется на поверхности опухолевых плазматических клеток при ММ, а также на В-клетках поздних стадий дифференцировки и нормальных плазматических клетках. В 2021–2022 гг. в США и Европейском союзе были одобрены для клинического применения у пациентов с рецидивами/рефрактерным течением ММ два препарата CAR T-клеток: идекабтаген виклейсел (ide-cel) и цилтакабтаген аутолейсел (cilta-cel). Исследования этих препаратов показали весьма обнадеживающие клинические результаты. Клеточные препараты к другим антигенам (GPRC5D, SLAMF7) находятся на ранних стадиях исследований. Настоящий обзор посвящен последним достижениям в сфере CAR Т-клеточной терапии ММ, представленным на недавних конгрессах ASH-2021 и ASCO-2022. Подробно освещаются результаты исследований KarMMa (ide-cel, II фаза) и CARTITUDE-1 (cilta-cel, IB–II фаза). В обзоре приводятся историческая справка по созданию CAR Т-клеток, данные доклинических и текущих клинических исследований в области ММ, освещаются вопросы возможных причин неудач и перспектив дальнейшего совершенствования данной технологии.

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