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:CAR-T cell therapy for triple-negative breast cancer and other solid tumors: preclinical and clinical progress.
CAR-T细胞治疗的一个挑战是选择最佳靶点以尽量减少靶向/脱靶毒性。抗原丢失和内在异质性导致的肿瘤逃逸是进一步的障碍。TROP2、GD2、ROR1、MUC1和EpCAM是有前景的靶点。通过应用带有趋化因子受体和/或组成性激活的白细胞介素受体的CAR,可能增强持久性和向肿瘤细胞的迁移。第四代CAR(TRUCKs)可能重定向T细胞以实现通用的细胞因子介导的杀伤。联合策略以及将CAR应用于其他免疫细胞可能逆转实体肿瘤所特有的抑制性免疫环境。
大多数乳腺癌相关死亡源于三阴性乳腺癌(TNBC)。分子异质性、侵袭性和缺乏有效疗法是治疗进展的主要障碍。嵌合抗原受体(CAR)-T细胞已成为TNBC中一种有前景的免疫治疗策略。该方法将抗体的抗原特异性与T细胞的效应功能相结合。涵盖领域:本综述探讨了CAR-T细胞疗法在实体瘤中提供的机会。随后考虑了TNBC中新兴靶点、正在进行的临床试验以及前瞻性临床意义。重点放在该治疗方法的关键挑战和可能的解决方案上。
INTRODUCTION: Most breast cancer-related deaths arise from triple-negative breast cancer (TNBC). Molecular heterogeneity, aggressiveness and the lack of effective therapies are major hurdles to therapeutic progress. Chimeric antigen receptor (CAR)-T cells have emerged as a promising immunotherapeutic strategy in TNBC. This approach combines the antigen specificity of an antibody with the effector function of T cells. AREAS COVERED: This review examines the opportunities provided by CAR-T cell therapies in solid tumors. Emerging targets, ongoing clinical trials, and prospective clinical implications in TNBC are considered later. An emphasis is placed on the key challenges and possible solutions for this therapeutic approach. EXPERT OPINION: A challenge for CAR-T cell therapy is the selection of the optimal targets to minimize on-target/off-tumor toxicity. Tumor escape via antigen loss and intrinsic heterogeneity is a further hurdle. TROP2, GD2, ROR1, MUC1 and EpCAM are promising targets. Persistence and trafficking to tumor cells may be enhanced by the implementation of CARs with a chemokine receptor and/or constitutively activated interleukin receptors. Fourth-generation CARs (TRUCKs) may redirect T-cells for universal cytokine-mediated killing. Combinatorial approaches and the application of CARs to other immune cells could revert the suppressive immune environment that characterizes solid neoplasms.
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