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 Therapy for Cancer: Latest Updates and Challenges, with a Focus on B-Lymphoid Malignancies and Selected Solid Tumours.
尽管如此,在标准治疗难治的晚期神经母细胞瘤中,抗GD2特异性CAR T细胞实现了60%的长期总生存率和63%的客观缓解率。
尽管在现代,免疫检查点阻断在治疗晚期恶性肿瘤方面取得了指数级进展,但生存结局仍不理想。细胞免疫治疗,如CAR-T 细胞,有潜力改善这一状况。CAR T细胞通过表达编码scFv结构域、CD3激活分子和共刺激结构域的转基因,将单克隆抗体的抗原特异性与T淋巴细胞的细胞毒性“力量”结合起来。尽管极少数情况下可能发生致命的细胞因子释放综合征,但CAR T细胞疗法为难治性CD19阳性B淋巴恶性肿瘤患者提供了一种重要的进一步治疗选择。然而,非恶性细胞上上皮肿瘤相关抗原的低水平表达使得CAR T细胞技术应用于常见实体癌具有挑战性,CAR T细胞在血液/淋巴微环境之外向转移性病灶迁移的潜在有限能力也是如此。尽管如此,在对标准治疗难治的晚期神经母细胞瘤中,抗GD2特异性CAR T细胞实现了60%的长期总生存率和63%的客观缓解。
Although exponential progress in treating advanced malignancy has been made in the modern era with immune checkpoint blockade, survival outcomes remain suboptimal. Cellular immunotherapy, such as chimeric antigen receptor T cells, has the potential to improve this. CAR T cells combine the antigen specificity of a monoclonal antibody with the cytotoxic 'power' of T-lymphocytes through expression of a transgene encoding the scFv domain, CD3 activation molecule, and co-stimulatory domains. Although, very rarely, fatal cytokine-release syndrome may occur, CAR T-cell therapy gives patients with refractory CD19-positive B-lymphoid malignancies an important further therapeutic option. However, low-level expression of epithelial tumour-associated-antigens on non-malignant cells makes the application of CAR T-cell technology to common solid cancers challenging, as does the potentially limited ability of CAR T cells to traffic outside the blood/lymphoid microenvironment into metastatic lesions. Despite this, in advanced neuroblastoma refractory to standard therapy, 60% long-term overall survival and an objective response in 63% was achieved with anti GD2-specific CAR T cells.
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