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Blood：治疗原发性中枢神经系统淋巴瘤（PCNSL）的新型药物

2018-07-10 MedSci MedSci原创

中枢神经系统淋巴瘤免疫抑制
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原发性中枢神经系统淋巴瘤（PCNSL）是一种罕见的侵袭性淋巴结外非霍奇金淋巴瘤。虽然以高剂量的甲氨蝶呤为基础的免疫化疗可获得很高的缓解率，但至少1/3的患者复发和死亡风险仍很大。治疗淋巴恶性肿瘤的新型药物实质性丰富了PCNSL的治疗方案。Gerald Illerhaus等人对新型药物治疗PCNSL的现有临床证据进行系统回顾、总结正在进行的研究并对未来展望进行讨论。新型药物的证据仍局限于非对照研究，

原发性中枢神经系统淋巴瘤（PCNSL）是一种罕见的侵袭性淋巴结外非霍奇金淋巴瘤。虽然以高剂量的甲氨蝶呤为基础的免疫化疗可获得很高的缓解率，但至少1/3的患者复发和死亡风险仍很大。治疗淋巴恶性肿瘤的新型药物实质性丰富了PCNSL的治疗方案。Gerald Illerhaus等人对新型药物治疗PCNSL的现有临床证据进行系统回顾、总结正在进行的研究并对未来展望进行讨论。

新型药物的证据仍局限于非对照研究，但是，最有前景的治疗方案包括依鲁替尼抑制bruton激酶、来那度胺进行免疫调节。靶向mTOR信号通路似乎与临床疗效无关，用单抗抑制免疫检查点的证据局限于经验证据。

后续研究应涵盖诱导和维持治疗两个概念，以及与不同作用机制的药物联合治疗。基于分子分析和复发模式分选患者应是未来对照试验的另一个方面，这也是改善PCNSL患者预后所亟待需要的。

原始出处：

Gerald Illerhaus， Elisabeth Schorb， and Benjamin Kasenda. Novel agents for primary central nervous system lymphoma (PCNSL)： evidence and perspectives.Blood  2018  ：blood-2018-01-791558；  doi： https：//doi.org/10.1182/blood-2018-01-791558

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    2019-02-09 ms7474195563676018

    #中枢神经系统淋巴瘤#

    0

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    2018-10-11 lg.zhao

    #CNS#

    0

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    2018-07-14 12498bb3m90(暂无昵称)

    #PCNSL#

    0

  4. 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topicList=[TopicDto(id=4935, encryptionId=4b8349356f, topicName=CNS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c737344, createdName=lg.zhao, createdTime=Thu Oct 11 10:47:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1947564, encodeId=b3d1194e564ef, content=<a href='/topic/show?id=4e0c13860de' target=_blank style='color:#2F92EE;'>#PCNSL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13860, encryptionId=4e0c13860de, topicName=PCNSL)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a5c2500147, createdName=12498bb3m90(暂无昵称), createdTime=Sat Jul 14 02:47:00 CST 2018, time=2018-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1846685, encodeId=6f7f184668543, content=<a href='/topic/show?id=d3a33e0306d' target=_blank style='color:#2F92EE;'>#原发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37030, encryptionId=d3a33e0306d, topicName=原发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Tue Aug 28 15:47:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283084, encodeId=7860128308430, content=<a href='/topic/show?id=4fade445192' target=_blank style='color:#2F92EE;'>#神经系统#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74451, encryptionId=4fade445192, topicName=神经系统)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02f5179, createdName=luoxiaog, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486359, encodeId=1f8b148635966, content=<a href='/topic/show?id=865a582869a' target=_blank style='color:#2F92EE;'>#新型药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58286, encryptionId=865a582869a, topicName=新型药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca58121482, createdName=ms1260584454294838, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571523, encodeId=56b415e152304, content=<a href='/topic/show?id=f7603e0370d' target=_blank style='color:#2F92EE;'>#原发性中枢神经系统淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37037, encryptionId=f7603e0370d, topicName=原发性中枢神经系统淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=46bd15746037, createdName=hxq78321, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1624226, encodeId=8777162422657, content=<a href='/topic/show?id=a9b2222e60a' target=_blank style='color:#2F92EE;'>#中枢神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22276, encryptionId=a9b2222e60a, topicName=中枢神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1fcf20658765, createdName=smlt2015, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330677, encodeId=7a713306e735, content=原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的侵袭性淋巴结外非霍奇金淋巴瘤.虽然以高剂量的甲氨蝶呤为基础的免疫化疗可获得很高的缓解率.但至少1/3的患者复发和死亡风险仍很大, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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    2018-08-28 jiyangfei

    #原发性#

    0

  5. 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topicList=[TopicDto(id=4935, encryptionId=4b8349356f, topicName=CNS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c737344, createdName=lg.zhao, createdTime=Thu Oct 11 10:47:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1947564, encodeId=b3d1194e564ef, content=<a href='/topic/show?id=4e0c13860de' target=_blank style='color:#2F92EE;'>#PCNSL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13860, encryptionId=4e0c13860de, topicName=PCNSL)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a5c2500147, createdName=12498bb3m90(暂无昵称), createdTime=Sat Jul 14 02:47:00 CST 2018, time=2018-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1846685, encodeId=6f7f184668543, content=<a href='/topic/show?id=d3a33e0306d' target=_blank style='color:#2F92EE;'>#原发性#</a>, 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encodeId=1f8b148635966, content=<a href='/topic/show?id=865a582869a' target=_blank style='color:#2F92EE;'>#新型药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58286, encryptionId=865a582869a, topicName=新型药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca58121482, createdName=ms1260584454294838, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571523, encodeId=56b415e152304, content=<a href='/topic/show?id=f7603e0370d' target=_blank style='color:#2F92EE;'>#原发性中枢神经系统淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37037, encryptionId=f7603e0370d, topicName=原发性中枢神经系统淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=46bd15746037, createdName=hxq78321, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1624226, encodeId=8777162422657, content=<a href='/topic/show?id=a9b2222e60a' target=_blank style='color:#2F92EE;'>#中枢神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22276, encryptionId=a9b2222e60a, topicName=中枢神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1fcf20658765, createdName=smlt2015, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330677, encodeId=7a713306e735, content=原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的侵袭性淋巴结外非霍奇金淋巴瘤.虽然以高剂量的甲氨蝶呤为基础的免疫化疗可获得很高的缓解率.但至少1/3的患者复发和死亡风险仍很大, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Tue Jul 10 21:54:57 CST 2018, time=2018-07-10, status=1, ipAttribution=)]
    2018-07-12 luoxiaog

    #神经系统#

    0

  6. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37030, encryptionId=d3a33e0306d, topicName=原发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Tue Aug 28 15:47:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283084, encodeId=7860128308430, content=<a href='/topic/show?id=4fade445192' target=_blank style='color:#2F92EE;'>#神经系统#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74451, encryptionId=4fade445192, topicName=神经系统)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02f5179, createdName=luoxiaog, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486359, encodeId=1f8b148635966, content=<a href='/topic/show?id=865a582869a' target=_blank style='color:#2F92EE;'>#新型药物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58286, encryptionId=865a582869a, topicName=新型药物)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fca58121482, createdName=ms1260584454294838, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571523, encodeId=56b415e152304, content=<a href='/topic/show?id=f7603e0370d' target=_blank style='color:#2F92EE;'>#原发性中枢神经系统淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37037, encryptionId=f7603e0370d, topicName=原发性中枢神经系统淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=46bd15746037, createdName=hxq78321, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1624226, encodeId=8777162422657, content=<a href='/topic/show?id=a9b2222e60a' target=_blank style='color:#2F92EE;'>#中枢神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22276, encryptionId=a9b2222e60a, topicName=中枢神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1fcf20658765, createdName=smlt2015, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330677, encodeId=7a713306e735, content=原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的侵袭性淋巴结外非霍奇金淋巴瘤.虽然以高剂量的甲氨蝶呤为基础的免疫化疗可获得很高的缓解率.但至少1/3的患者复发和死亡风险仍很大, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Tue Jul 10 21:54:57 CST 2018, time=2018-07-10, status=1, ipAttribution=)]
    2018-07-12 ms1260584454294838

    #新型药物#

    0

  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37030, encryptionId=d3a33e0306d, topicName=原发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8e4c53, createdName=jiyangfei, createdTime=Tue Aug 28 15:47:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1283084, encodeId=7860128308430, content=<a href='/topic/show?id=4fade445192' target=_blank style='color:#2F92EE;'>#神经系统#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74451, encryptionId=4fade445192, topicName=神经系统)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02f5179, createdName=luoxiaog, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486359, 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createdName=hxq78321, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1624226, encodeId=8777162422657, content=<a href='/topic/show?id=a9b2222e60a' target=_blank style='color:#2F92EE;'>#中枢神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22276, encryptionId=a9b2222e60a, topicName=中枢神经)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1fcf20658765, createdName=smlt2015, createdTime=Thu Jul 12 10:47:00 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330677, encodeId=7a713306e735, content=原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的侵袭性淋巴结外非霍奇金淋巴瘤.虽然以高剂量的甲氨蝶呤为基础的免疫化疗可获得很高的缓解率.但至少1/3的患者复发和死亡风险仍很大, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/02/7354b3539aae6a0ccb1e0fff04c12084.jpg, createdBy=205b1984786, createdName=随梦飞扬, createdTime=Tue Jul 10 21:54:57 CST 2018, time=2018-07-10, status=1, ipAttribution=)]
    2018-07-12 hxq78321

    #原发性中枢神经系统淋巴瘤#

    0

  8. 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    2018-07-12 smlt2015

    #中枢神经#

    0

  9. 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    2018-07-10 随梦飞扬

    原发性中枢神经系统淋巴瘤(PCNSL)是一种罕见的侵袭性淋巴结外非霍奇金淋巴瘤.虽然以高剂量的甲氨蝶呤为基础的免疫化疗可获得很高的缓解率.但至少1/3的患者复发和死亡风险仍很大

    0