中国癌症防治杂志2026，Vol.18Issue(4)：464-478,15.DOI:10.27054/j.cnki.ISSN.1674-5671.2026.04.09
大B细胞淋巴瘤CAR-T细胞疗效预测与风险分层研究进展
Research progress on efficacy prediction and risk stratification of CAR-T cell therapy in large B-cell lymphoma
摘要
Abstract
Chimeric antigen receptor(CAR)-T cell therapy has substantially improved outcomes in patients with relapsed/refractory large B-cell lymphoma(R/R LBCL);however,interindividual variability in efficacy remains considerable,and the efficacy prediction and risk stratification across the entire treatment course remain major challenges.Following the treatment timeline,this review categorizes efficacy-related indicators into four groups according to their roles at different stages of treatment:pre-treatment risk stratification,early post-infusion response assessment,dynamic relapse monitoring,and prognostic evaluation after treatment failure.It further clarifies what should be measured at each timepoint,why it should be measured,and how the results inform subsequent decisions.We review advances regarding baseline and early positron emission tomography(PET)metabolic parameters,circulating tumor DNA(ctDNA)clearance kinetics,CAR-T cell product characteristics,tumor genomics and the immune microenvironment,and host factors.Most indicators lack unified cut-offs and prospective validation.Future efforts should focus on standardizing detection methods,conducting prospective multicenter studies,and exploring directions such as artificial intelligence and foundation models,measurable residual disease(MRD)-guided strategies,dual-targeted CAR-T,CAR-NK,and in vivo CAR-T,so as to promote stratified,individualized therapy.关键词
大B细胞淋巴瘤/嵌合抗原受体T/疗效预测/风险分层/分子影像/循环肿瘤DNAKey words
Large B-cell lymphoma/Chimeric antigen receptor T/Efficacy prediction/Risk stratification/Molecular imaging/Circu-lating tumor DNA分类
医药卫生引用本文复制引用
王博宇,王亮..大B细胞淋巴瘤CAR-T细胞疗效预测与风险分层研究进展[J].中国癌症防治杂志,2026,18(4):464-478,15.基金项目
癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项(2025ZD0544300) （2025ZD0544300）
