Les thérapies cellulaires dans le traitement de la LLC et du LNHi : les agents thérapeutiques en cours de développement
Résumé
Des thérapies cellulaires avancées ont été introduites au Canada au cours des deux dernières années. La thérapie par lymphocytes T à récepteur antigénique chimérique (CAR T-cell) est actuellement le traitement de référence du lymphome diffus à grandes cellules B (LDGCB), de la leucémie lymphoblastique aiguë (LLA) récidivante/ réfractaire (RR) chez les patients âgés de moins de 26 ans, et, plus récemment, du lymphome à cellules du manteau en troisième intention. Ces thérapies innovantes gagnent aujourd’hui en importance dans le traitement du LDGCB, la FDA les ayant récemment approuvées en deuxième intention chez les patients candidats à une greffe de cellules souches, à la suite de récents essais de phase III. Un autre exemple d’immunothérapie innovante est celui des activateurs de cellules T bispécifiques (BiTEs), qui ont été étudiés dans de nombreuses tumeurs malignes à cellules B, mais qui ne sont pas encore approuvés au Canada.
Le paysage thérapeutique du lymphome non hodgkinien indolent (LNHi) et de la leucémie lymphoïde chronique (LLC) a évolué au cours des dernières années, de nombreuses thérapies innovantes étant à l’étude ou devenant disponibles. Cependant, les besoins thérapeutiques des patients atteints de LNHi RR et de LLC réfractaire aux inhibiteurs de la tyrosine kinase de Bruton (BTK) et du lymphome à cellules B-2 (BCL2) restent non satisfaits. Cet article est consacré aux thérapies cellulaires que les cliniciens canadiens pourront probablement utiliser dans un avenir proche pour traiter les patients atteints de LNHi ou de LLC.
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