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:Paving the Way to Solid Tumors: Challenges and Strategies for Adoptively Transferred Transgenic T Cells in the Tumor Microenvironment.
T 细胞在抗肿瘤免疫应答中发挥重要作用。
T细胞是抗肿瘤免疫应答的重要参与者。过去几年中,通过过继转移基因修饰的自体T细胞治疗癌症已进入临床实践;这些细胞表达T细胞受体(TCR)或嵌合抗原受体(CAR),从而被特异性重定向至肿瘤。目前,靶向CD19及日益受到关注的靶向BCMA的工程化CAR-T细胞已获批用于治疗血液系统恶性肿瘤,并取得了部分令人瞩目的疗效。然而,转基因T细胞用于实体瘤治疗仍更为困难;要控制肿瘤,必须克服高度免疫抑制性肿瘤微环境(TME)中的多重障碍。本文聚焦这些疗法在三个层面的挑战:如何浸润肿瘤、如何发挥有效抗肿瘤活性,以及如何克服T细胞耗竭和功能障碍。我们探讨通过工程化改造TME或转基因T细胞本身、使其能响应环境变化,从而为强效转基因T细胞介导的肿瘤清除铺平道路的不同策略。
T cells are important players in the antitumor immune response. Over the past few years, the adoptive transfer of genetically modified, autologous T cells-specifically redirected toward the tumor by expressing either a T cell receptor (TCR) or a chimeric antigen receptor (CAR)-has been adopted for use in the clinic. At the moment, the therapeutic application of CD19- and, increasingly, BCMA-targeting-engineered CAR-T cells have been approved and have yielded partly impressive results in hematologic malignancies. However, employing transgenic T cells for the treatment of solid tumors remains more troublesome, and numerous hurdles within the highly immunosuppressive tumor microenvironment (TME) need to be overcome to achieve tumor control. In this review, we focused on the challenges that these therapies must face on three different levels: infiltrating the tumor, exerting efficient antitumor activity, and overcoming T cell exhaustion and dysfunction. We aimed to discuss different options to pave the way for potent transgenic T cell-mediated tumor rejection by engineering either the TME or the transgenic T cell itself, which responds to the environment.
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