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原发性脑肿瘤的 CAR-T 细胞治疗:当前研究与未来

英文原题:CAR T Cell Therapy in Primary Brain Tumors: Current Investigations and the Future.

PubMed 2022/02/21(内容时间) Front Immunol Q1 · IF 7(JCR 2025)

研究概要

CAR-T 细胞(CAR T细胞)是经过工程化改造的细胞,表达针对特定肿瘤抗原(TA)的嵌合抗原受体(CAR),从而能够识别并清除癌细胞。

中文摘要

CAR-T 细胞(CAR T细胞)是经过工程化改造的细胞,表达针对特定肿瘤抗原(TA)的嵌合抗原受体(CAR),能够识别并清除癌细胞。CAR T细胞疗法在血液系统恶性肿瘤中取得的显著临床效果,激发了人们开发此类疗法用于实体瘤(包括脑肿瘤)的兴趣。胶质母细胞瘤(GBM)是成人中最常见的原发性脑肿瘤,由于其高度侵袭性,预后较差。儿童脑肿瘤同样具有侵袭性,因此是儿童癌症相关死亡的主要原因。CAR T细胞疗法是治疗这些恶性肿瘤的一条有前景的途径。在临床前研究和临床试验中,已有多个特异性TA被作为靶点,如EGFR/EGFRvIII、IL13R 2、B7-H3和HER2。遗憾的是,针对脑肿瘤的CAR T细胞由于TA异质性、从血液向肿瘤部位迁移困难以及免疫抑制性肿瘤微环境等原因,疗效有限。在此,我们综述当前CAR T细胞治疗癌症的方法,特别聚焦于脑肿瘤。我们还描述了一种利用聚焦超声控制工程化CAR T细胞激活的新技术,以实现更安全的细胞疗法。最后,我们总结了为提高疗效和克服CAR T细胞疗法历史局限性而开发的联合策略。

展开英文摘要原文

Chimeric antigen receptor T cells (CAR T cells) are engineered cells expressing a chimeric antigen receptor (CAR) against a specific tumor antigen (TA) that allows for the identification and elimination of cancer cells. The remarkable clinical effect seen with CAR T cell therapies against hematological malignancies have attracted interest in developing such therapies for solid tumors, including brain tumors. Glioblastoma (GBM) is the most common primary brain tumor in adults and is associated with poor prognosis due to its highly aggressive nature. Pediatric brain cancers are similarly aggressive and thus are a major cause of pediatric cancer-related death. CAR T cell therapy represents a promising avenue for therapy against these malignancies. Several specific TAs, such as EGFR/EGFRvIII, IL13R 2, B7-H3, and HER2, have been targeted in preclinical studies and clinical trials. Unfortunately, CAR T cells against brain tumors have showed limited efficacy due to TA heterogeneity, difficulty trafficking from blood to tumor sites, and the immunosuppressive tumor microenvironment. Here, we review current CAR T cell approaches in treating cancers, with particular focus on brain cancers. We also describe a novel technique of focused ultrasound controlling the activation of engineered CAR T cells to achieve the safer cell therapies. Finally, we summarize the development of combinational strategies to improve the efficacy and overcome historical limitations of CAR T cell therapy.

论文信息

作者
Lin YJ、Mashouf LA、Lim M
单位
Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, United States.United States
文献类型
综述
期刊
Frontiers in immunology2022
原文标识
PubMed 35265074 · DOI 10.3389/fimmu.2022.817296