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:CAR-T cell Therapies for B-cell Lymphoid Malignancies: Identifying Targets Beyond CD19.
嵌合抗原受体(CAR)是一种人工合成的工程化受体,其抗原识别结构域来源于高特异性单克隆抗体,能够靶向肿瘤细胞表面的分子。
嵌合抗原受体(CAR)是一种人工工程化受体,其抗原识别结构域来源于高特异性单克隆抗体,能够靶向肿瘤细胞表面分子。通过基因工程使T细胞表达CAR,从而将抗体的抗原识别能力与T细胞的效应功能相结合。靶表面分子的选择对于CAR的制备至关重要。理想情况下,靶表面分子应仅限于肿瘤细胞,在正常组织上表达极低或不表达。多种靶向CD19的CAR-T细胞疗法已获批用于治疗对其他疗法难治的B细胞淋巴系统恶性肿瘤,包括惰性和侵袭性B细胞非霍奇金淋巴瘤(NHL)以及B细胞急性淋巴细胞白血病(B-ALL)。尽管结果令人瞩目,但许多侵袭性和难治性B细胞恶性肿瘤患者对CD19 CAR-T细胞疗法无应答或治疗后复发。因此,目前正在评估多种额外策略以克服这些局限性。本综述讨论了其他有前景的CAR-T细胞靶点的研究,包括CD20、CD22、BAFF-R、ROR1、CD70、BCR复合物、kappa/lambda轻链、多靶点CAR-T细胞,以及CAR-T细胞疗法与不同药物的联合方案。
Chimeric antigen receptors (CARs) are synthetic engineered receptors with an antigen recognition domain derived from a high-specificity monoclonal antibody that can target surface molecules on tumor cells. T cells are genetically engineered to express CARs, thereby harnessing the antigen-recognition ability of antibodies and effector function of T cells. Target surface molecule selection is crucial for manufacturing CARs. Ideally, a target surface molecule should be restricted to tumor cells and minimally expressed or absent on normal tissues. Different CD19-targeted CAR-T cell therapies have been approved for the treatment of B-cell lymphoid malignancies that are refractory to other therapies, including indolent and aggressive B-cell non-Hodgkin lymphomas (NHL) and B-cell acute lymphoblastic leukemia (B-ALL). Despite impressive results, many patients with aggressive and refractory B-cell malignancies do not respond to or relapse after CD19 CAR-T cell therapies. Thus, several additional strategies are currently being evaluated to overcome these limitations. This review discusses studies on other promising CAR-T cell targets, including CD20, CD22, BAFF-R, ROR1, CD70, BCR complex, kappa/lambda light chains, multitargeted CAR-T cells, and combinations of CAR-T cell therapy with different drugs.
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