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:CAR-T Cell Therapy in Hematological Malignancies: Current Opportunities and Challenges.
CAR-T Cell Therapy in Hematological Malignancies: Current Opportunities and Challenges.
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CAR-T(CAR-T)细胞疗法是癌症治疗的重要突破,在血液系统恶性肿瘤、尤其是复发/难治性B细胞恶性肿瘤中取得前所未有的成功。目前CD19和BCMA是CAR-T 最常见靶点,同时研究者正在探索众多新治疗靶点。然而CAR-T 相关不良事件可能严重甚至危及生命,包括细胞因子释放综合征(CRS)、CAR-T 细胞相关脑病综合征(CRES)、感染、血细胞减少及CRS相关凝血障碍。此外,受抗原逃逸、CAR-T 细胞持留有限和免疫抑制性肿瘤微环境影响,相当一部分患者在CAR-T 治疗后复发。因此,本综述聚焦血液系统恶性肿瘤CAR-T 疗法的进展和挑战,包括有前景的治疗靶点、CAR-T 相关毒性及治疗耐药,并提出一些实践建议。
Chimeric antigen receptor T (CAR-T) cell therapy represents a major breakthrough in cancer treatment, and it has achieved unprecedented success in hematological malignancies, especially in relapsed/refractory (R/R) B cell malignancies. At present, CD19 and BCMA are the most common targets in CAR-T cell therapy, and numerous novel therapeutic targets are being explored.
However, the adverse events related to CAR-T cell therapy might be serious or even life-threatening, such as cytokine release syndrome (CRS), CAR-T-cell-related encephalopathy syndrome (CRES), infections, cytopenia, and CRS-related coagulopathy.
In addition, due to antigen escape, the limited CAR-T cell persistence, and immunosuppressive tumor microenvironment, a considerable proportion of patients relapse after CAR-T cell therapy.
Thus, in this review, we focus on the progress and challenges of CAR-T cell therapy in hematological malignancies, such as attractive therapeutic targets, CAR-T related toxicities, and resistance to CAR-T cell therapy, and provide some practical recommendations.
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