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:Chimeric Antigen Receptor T-cell Therapy in Cancer: A Critical Review.
靶向癌症治疗作用于靶向分子,对正常细胞的毒性较小,对癌细胞的作用更具特异性。
靶向癌症治疗作用于特定分子,对正常细胞毒性较小,并能更具特异性地作用于癌细胞。抑制恶性肿瘤生长的两种主要策略是阻断T细胞抑制信号,或利用T细胞及肿瘤特异性抗体将T细胞引导至肿瘤靶点。CAR由三个结构域组成,包括胞外抗原识别结构域和胞内T细胞信号结构域,后者参与T细胞活化。CAR-T治疗最常见的两种不良反应是细胞因子释放综合征(CRS)和细胞相关神经毒性综合征(CANS)。CAR胞内信号结构域具有可调节性,可直接或间接抵消肿瘤细胞造成的共刺激分子下调。CAR-T疗法的主要缺点是脱靶毒性。表达CD3、CD123、Lewis Y、CLL-1、CD44v6、FLT3和叶酸受体靶向CAR的治疗策略,在急性髓系白血病(AML)临床前模型中显示出有前景的结果。近期研究显示,B7-H3 CAR-T细胞在胰腺导管腺癌(PDAC)、卵巢癌、神经母细胞瘤及多种儿童恶性肿瘤的临床前模型中具有显著抗癌活性。SUPRA CAR能够无需重新工程化即可改变靶点,是CAR领域的一项新近创新。鉴于NK细胞在肿瘤发生发展和转移防御中的重要作用,包括NK细胞过继转移在内的NK细胞免疫疗法已受到广泛关注。随着改进的细胞制备方法、新型细胞工程策略、精准基因组编辑技术和联合治疗方案不断发展,我们相信CAR-T细胞很快将成为现货型、成本可负担且有望治愈肿瘤的疗法。
Targeted cancer therapy acts on targeted molecules, is less toxic to normal cells, and acts more specifically on cancer cells. The two primary strategies for preventing malignancy growth are the blocking of T-cell repression signals or forwarding of T-cell to tumor target with both T and tumor-specific antibodies. The CAR comprises three domains, the extracellular antigen recognition domain and the intracellular T-cell signaling domain, which participate in activating T-cells. The two most common adverse effects of CAR T-cell treatment are cytokine release syndrome (CRS) and cell-associated neurotoxicity syndrome (CANS). The adaptability of intracellular signaling domains inside CARs allows the cell to counterbalance the downregulation of costimulatory molecules produced by tumor cells, either indirectly or directly. The major disadvantage of CAR-T cell therapy is off-target toxicity. Treatment with CARs expressing CD3, CD123, Lewis Y, CLL-1, CD44v6, FLT3, and folate receptors showed promising results in preclinical models of acute myeloid leukemia (AML). A recent study has revealed that B7-H3 CART cells exhibit significant anticancer efficacy in a variety of solid tumor preclinical models, including PDAC, ovarian cancer, neuroblastoma, and various pediatric malignancies. The notion of SUPRA CAR, with its unique capacity to alter targets without the need to re-engineer, is a recent innovation in CAR. Given the importance of NK cells in tumor development and metastatic defence, NK cell-based immunotherapies, including adoptive transfer of NK cells, have garnered a lot of interest. With the advancement of improved cellular manufacturing methods, novel cellular engineering strategies, precision genome editing technologies, and combination therapy approaches, we firmly believe that CAR-T cells will soon become an off-the-shelf, cost-effective, and potentially curative therapy for oncogenesis.
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