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.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Emerging Strategies in TCR-Engineered T Cells.
Emerging Strategies in TCR-Engineered T Cells.
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近年来,癌症免疫治疗取得了巨大进展,这体现在从患者来源的TIL(肿瘤浸润淋巴细胞)、嵌合抗原受体(CAR)修饰的T细胞(CAR-T)和T细胞受体(TCR)工程化T细胞(TCR-T)的过继性细胞转移(ACT)中获得的显著临床应答。TCR-T使用经过优化以结合肿瘤的特定TCRS,能够识别来源于细胞表面和细胞内靶点的表位,包括肿瘤相关抗原、癌症生殖系抗原、病毒癌蛋白以及主要隔离在肿瘤细胞质和细胞核中的肿瘤特异性新抗原(neoAgs)。
此外,由于TCRS天然进化用于敏感抗原检测,它们能够识别远低于CAR-T 激活所需浓度的表位。因此,TCR-T在治疗人类癌症方面具有巨大前景。在这篇聚焦综述中,我们总结了关于TCR-T挑战和机遇的基础、转化和临床见解。
我们回顾了当前ACT中使用的新兴策略,指出了局限性,并提出了可能的解决方案。我们强调了靶向肿瘤特异性新抗原的重要性,并概述了一种将新抗原疫苗、检查点阻断疗法和新抗原特异性TCR-T过继转移相结合的策略,以产生真正肿瘤特异性的疗法,该疗法能够穿透实体瘤并抵抗免疫抑制性肿瘤微环境。
我们相信这种联合方法应能显著改善癌症免疫治疗,尤其是对实体瘤,并可能为根除多种癌症提供一种通用策略。
Immunotherapy of cancer has made tremendous progress in recent years, as demonstrated by the remarkable clinical responses obtained from adoptive cell transfer (ACT) of patient-derived tumor infiltrating lymphocytes, chimeric antigen receptor (CAR)-modified T cells (CAR-T) and T cell receptor (TCR)-engineered T cells (TCR-T).
TCR-T uses specific TCRS optimized for tumor engagement and can recognize epitopes derived from both cell-surface and intracellular targets, including tumor-associated antigens, cancer germline antigens, viral oncoproteins, and tumor-specific neoantigens (neoAgs) that are largely sequestered in the cytoplasm and nucleus of tumor cells.
Moreover, as TCRS are naturally developed for sensitive antigen detection, they are able to recognize epitopes at far lower concentrations than required for CAR-T activation.
Therefore, TCR-T holds great promise for the treatment of human cancers. In this focused review, we summarize basic, translational, and clinical insights into the challenges and opportunities of TCR-T.
We review emerging strategies used in current ACT, point out limitations, and propose possible solutions.
We highlight the importance of targeting tumor-specific neoAgs and outline a strategy of combining neoAg vaccines, checkpoint blockade therapy, and adoptive transfer of neoAg-specific TCR-T to produce a truly tumor-specific therapy, which is able to penetrate into solid tumors and resist the immunosuppressive tumor microenvironment.
We believe such a combination approach should lead to a significant improvement in cancer immunotherapies, especially for solid tumors, and may provide a general strategy for the eradication of multiple cancers.
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