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:Migratory Engineering of T Cells for Cancer Therapy.
Migratory Engineering of T Cells for Cancer Therapy.
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过继性细胞治疗(ACT),尤其是嵌合抗原受体(CAR)T细胞治疗,代表了一种适应性且多功能的癌症治疗策略。在血液系统恶性肿瘤治疗中令人信服的结果已促使FDA批准了若干CAR-T 细胞疗法用于特定的难治性疾病。相比之下,使用过继转移T细胞治疗实体瘤在临床试验中尚未展现出令人信服的疗效。ACT在实体瘤中失败的主要原因之一是转移的T细胞向肿瘤部位的运输或进入不良。肿瘤采用多种机制将自身与免疫细胞浸润隔离,通常导致只有部分转移的T细胞能够到达肿瘤部位。为克服这一瓶颈,目前正在进行大量努力,通过工程化改造T细胞来改善ACT对实体瘤的进入。在本综述中,我们概述了人类肿瘤中的免疫细胞浸润以及肿瘤用于免疫排斥的机制。我们将讨论通过工程化改造T细胞来规避这些屏障的方法。我们对正在进行的针对免疫细胞迁移以改善ACT的临床试验及其在实体瘤中的前景进行了展望。
Adoptive cell therapy (ACT) and chimeric antigen receptor (CAR) T cell therapy in particular represents an adaptive, yet versatile strategy for cancer treatment. Convincing results in the treatment of hematological malignancies have led to FDA approval for several CAR T cell therapies in defined refractory diseases. In contrast, the treatment of solid tumors with adoptively transferred T cells has not demonstrated convincing efficacy in clinical trials.
One of the main reasons for ACT failure in solid tumors is poor trafficking or access of transferred T cells to the tumor site. Tumors employ a variety of mechanisms shielding themselves from immune cell infiltrates, often translating to only fractions of transferred T cells reaching the tumor site.
To overcome this bottleneck, extensive efforts are being undertaken at engineering T cells to improve ACT access to solid tumors. In this review, we provide an overview of the immune cell infiltrate in human tumors and the mechanisms tumors employ toward immune exclusion.
We will discuss ways in which T cells can be engineered to circumvent these barriers.
We give an outlook on ongoing clinical trials targeting immune cell migration to improve ACT and its perspective in solid tumors.
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