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:Expanding the role of interventional oncology for advancing precision immunotherapy of solid tumors.
Expanding the role of interventional oncology for advancing precision immunotherapy of solid tumors.
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嵌合抗原受体(CAR)T细胞过继治疗已被证明可有效治疗血液系统恶性肿瘤,但实体瘤中的疗效受到多种因素限制,包括肿瘤内浸润不足、抗原负荷导致效应细胞耗竭,以及免疫抑制性肿瘤微环境。近期临床试验和临床前研究为局部区域CAR-T 细胞递送、肿瘤微环境预处理以及维持T细胞活性的辅助治疗提供了令人鼓舞的证据。介入肿瘤学是介入放射学的一个亚专科,利用影像引导,通过经皮或导管介入开展局部、非手术治疗或检查实体瘤。介入肿瘤学与免疫疗法具有独特的协同潜力;相关研究已显示,其可提高治疗效果,同时降低全身治疗相关毒性。介入肿瘤学除可协助CAR-T 细胞递送和预处理肿瘤微环境、促进效应细胞存活与功能外,还可通过选择性多点肿瘤取样和导管静脉采样监测治疗应答。本文概述介入肿瘤学及其多种操作,并讨论其推进实体瘤CAR-T 细胞免疫治疗的潜力。
Adoptive cell therapy with chimeric antigen receptors (CAR) T cells has proven effective for hematologic malignancies, but success in solid tumors has been impeded by poor intratumoral infiltration, exhaustion of effector cells from antigen burden, and an immunosuppressive tumor microenvironment. Results from recent clinical trials and preclinical studies lend promising evidence of locoregional approaches for CAR T cell delivery, priming the tumor microenvironment, and performing adjuvant therapies that sustain T cell activity. Interventional oncology is a subspeciality of interventional radiology where imaging guidance is used to perform percutaneous and catheter-directed procedures for localized, non-surgical therapy or interrogation of solid tumors.
Interventional oncology provides unique synergies with immunotherapy, which has been well-studied to improve treatment efficacy while reducing toxicities associated with systemic treatment.
Besides aiding in CAR T cell delivery, priming, or the stimulation of the tumor microenvironment to promote effector survival and function, interventional oncology can also aid in the monitoring of treatment response through selective, multiplex tumor sampling and catheter-based venous sampling. This review presents an overview of interventional oncology, its various procedures, and its potential for advancing CAR T cell immunotherapy of solid tumors.
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