CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Challenges and Prospects for Designer T and NK Cells in Glioblastoma Immunotherapy.
Challenges and Prospects for Designer T and NK Cells in Glioblastoma Immunotherapy.
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胶质母细胞瘤(GBM)是最常见、侵袭性最强的原发性脑肿瘤,预后极差。确诊时的治疗疗效有限,复发时也没有标准治疗。新的个体化治疗方案正在研究中,但GBM这类异质性肿瘤仍存在挑战。基因编辑技术带来了重大突破,使人们能够设计新的分子免疫治疗,并与放化疗联合,以期为患者带来持久的生存获益。本文回顾相关文献,探讨如何将前沿分子基因编辑技术应用于已知及新兴肿瘤相关抗原,以增强针对GBM的CAR-T 细胞和NK细胞疗法。要显著改善患者生存,必须在限制神经毒性、避免肿瘤抗原丢失和治疗耐药的同时,促进过继转移细胞长期持续存在。我们讨论脑部组织环境给治疗实施和获得持续临床应答带来的机遇与挑战。
Glioblastoma (GBM) is the most prevalent, aggressive primary brain tumour with a dismal prognosis. Treatment at diagnosis has limited efficacy and there is no standardised treatment at recurrence. New, personalised treatment options are under investigation, although challenges persist for heterogenous tumours such as GBM. Gene editing technologies are a game changer, enabling design of novel molecular-immunological treatments to be used in combination with chemoradiation, to achieve long lasting survival benefits for patients.
Here, we review the literature on how cutting-edge molecular gene editing technologies can be applied to known and emerging tumour-associated antigens to enhance chimeric antigen receptor T and NK cell therapies for GBM. A tight balance of limiting neurotoxicity, avoiding tumour antigen loss and therapy resistance, while simultaneously promoting long-term persistence of the adoptively transferred cells must be maintained to significantly improve patient survival.
We discuss the opportunities and challenges posed by the brain contexture to the administration of the treatments and achieving sustained clinical responses.
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