刘汇洪 王立茹

    【摘要】 嵌合抗原受体T细胞(CAR-T)免疫疗法快速发展，为多发性骨髓瘤(MM)治疗带来新的曙光，尤其B细胞成熟抗原(BCMA)作为迄今为止最成功的靶标，靶向BCMA CAR-T疗法可以使MM的症状获得持久且深度的缓解，在复发难治性多发性骨髓瘤(RRMM)治疗中取得突破性进展。但由于抗原逃逸、CAR-T衰竭等因素，多数患者仍会进展或复发，靶向BCMA CAR-T治疗后复发或难治患者的后续治疗缺乏标准方案。同时，复杂、昂贵且耗时的个性化CAR-T制造流程也限制其临床疗效的发挥。针对此现状，该综述总结了靶向BCMA CAR-T治疗的局限性及其机制，同时结合MM治疗领域新进展，提出改善进展或RRMM患者结局的潜在优化治疗策略。

    【关键词】 B细胞成熟抗原 CAR-T疗法 复发难治性多发性骨髓瘤 耐药性

    Current Limitations and Potential Strategies of BCMA-targeted CAR-T Therapy in Relapsed Refractory Multiple Myeloma/LIU Huihong， WANG Liru. //Medical Innovation of China， 2024， 21(15)： -188

    [Abstract] The rapid development of chimeric antigen receptor T cell (CAR-T) immunotherapy has brought new light to the treatment of multiple myeloma (MM)， among which B cell mature antigen is one of the most popular and successful target. BCMA-targeted CAR-T therapy has demonstrated deep and durable remissions of myeloma symptoms， a breakthrough in the treatment of relapsed refractory multiple myeloma (RRMM). However， due to antigen escape， CAR-T failure and other factors， most patients will still progress or relapse ......