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:Next Generation Natural Killer Cells for Cancer Immunotherapy.
Next Generation Natural Killer Cells for Cancer Immunotherapy.
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近年来癌症免疫治疗已成为主流,多个产品获批临床使用,并成为部分恶性肿瘤的标准治疗。嵌合抗原受体(CAR)T 细胞疗法治疗血液系统恶性肿瘤显示出显著疗效;但生产复杂、成本高,目前还可能引发细胞因子释放综合征(CRS)等危及生命的不良事件。现有 CAR-T 疗法的局限促使人们关注风险更低、生产限制更少的替代免疫疗法。自然杀伤(NK)细胞是一类具有强效抗病毒和抗肿瘤活性的免疫效应细胞,可快速识别并杀伤癌细胞,无需预先刺激。尽管 NK 细胞天然具有细胞毒潜能,越来越多证据显示,对其进行工程化改造可提升肿瘤靶向能力、延长宿主体内持续存在时间,并增强抵抗恶劣肿瘤微环境(TME)的适应性。基于 NK 细胞的免疫疗法可开发异体现货型产品,有望降低成本并使患者及时获得治疗。本综述聚焦癌症免疫治疗中 NK 细胞工程化进展,讨论 NK 细胞来源、工程化技术、当前工程化 NK 细胞临床试验、适用于 NK 细胞的受体工程改造进展,以及避免受者免疫反应的隐形策略。
最后展望下一代 NK 细胞产品,即功能、适应性和肿瘤浸润能力增强,并能够克服肿瘤异质性和免疫逃逸的装甲 NK 细胞。
In recent years, immunotherapy for cancer has become mainstream with several products now authorized for therapeutic use in the clinic and are becoming the standard of care for some malignancies. Chimeric antigen receptor (CAR)-T cell therapies have demonstrated substantial efficacy for the treatment of hematological malignancies; however, they are complex and currently expensive to manufacture, and they can generate life-threatening adverse events such as cytokine release syndrome (CRS). The limitations of current CAR-T cells therapies have spurred an interest in alternative immunotherapy approaches with safer risk profiles and with less restrictive manufacturing constraints.
Natural killer (NK) cells are a population of immune effector cells with potent anti-viral and anti-tumor activity; they have the capacity to swiftly recognize and kill cancer cells without the need of prior stimulation. Although NK cells are naturally equipped with cytotoxic potential, a growing body of evidence shows the added benefit of engineering them to better target tumor cells, persist longer in the host, and be fitter to resist the hostile tumor microenvironment (TME).
NK-cell-based immunotherapies allow for the development of allogeneic off-the-shelf products, which have the potential to be less expensive and readily available for patients in need. In this review, we will focus on the advances in the development of engineering of NK cells for cancer immunotherapy.
We will discuss the sourcing of NK cells, the technologies available to engineer NK cells, current clinical trials utilizing engineered NK cells, advances on the engineering of receptors adapted for NK cells, and stealth approaches to avoid recipient immune responses.
We will conclude with comments regarding the next generation of NK cell products, i. e. , armored NK cells with enhanced functionality, fitness, tumor-infiltration potential, and with the ability to overcome tumor heterogeneity and immune evasion.
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