决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Early-phenotype CAR-T cells for the treatment of pediatric cancers.
Early-phenotype CAR-T cells for the treatment of pediatric cancers.
CAR-T 细胞疗法是治疗儿童肿瘤的一种有前景的方法,尤其是对标准治疗无反应的高危肿瘤。
嵌合抗原受体(CAR)T细胞疗法是治疗儿童癌症的一种有前景的方法,尤其适用于对标准治疗无应答的高危肿瘤。CAR T细胞已成功治疗部分血液系统恶性肿瘤,但靶向实体瘤的CAR T细胞迄今疗效有限,原因包括其长期存续和增殖能力较差等。越来越多证据表明,在体外维持CAR T细胞处于较早、分化程度较低的状态,可增强其在体内的持久性、增殖能力和抗肿瘤作用。儿童非常适合接受分化程度较低的CAR T细胞,因为其外周T细胞库以初始T细胞为主,可较容易地采集大量细胞来制备早期表型CAR T细胞。尽管已有多项研究报告成功制备早期CAR T细胞的不同方法,目前仅有少数临床试验在成人中评估此类细胞,尚无针对儿童早期CAR T细胞的临床试验。本文总结了维持CAR T细胞早期表型的不同策略,并介绍相关证据,说明这一方法或对儿童癌症治疗尤为重要。
Chimeric antigen receptor (CAR)-T-cell therapy is a promising approach for the treatment of childhood cancers, particularly high-risk tumors that fail to respond to standard therapies. CAR-T cells have been highly successful in treating some types of hematological malignancies. However, CAR-T cells targeting solid cancers have had limited success so far for multiple reasons, including their poor long-term persistence and proliferation. Evidence is emerging to show that maintaining CAR-T cells in an early, less-differentiated state in vitro results in superior persistence, proliferation, and antitumor effects in vivo. Children are ideal candidates for receiving less-differentiated CAR-T cells, because their peripheral T-cell pool primarily comprises na ve cells that could readily be harvested in large numbers to generate early-phenotype CAR-T cells. Although several studies have reported different approaches to successfully generate early CAR-T cells, there are only a few clinical trials testing these in adult patients. No trials are currently testing early CAR-T cells in children. Here, we summarize the different strategies used to maintain CAR-T cells in an early phenotypic stage and present evidence suggesting that this approach may be particularly relevant to treating childhood cancers.
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