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:Leveraging immune resistance archetypes in solid cancer to inform next-generation anticancer therapies.
Leveraging immune resistance archetypes in solid cancer to inform next-generation anticancer therapies.
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抗癌免疫疗法,如免疫检查点抑制剂、双特异性抗体和CAR-T 细胞,已改善了多种恶性肿瘤患者的结局。然而,由于肿瘤微环境的原发性或适应性/获得性免疫抵抗机制,大多数患者要么初始无应答,要么无法表现出持久应答。这些抑制性程序繁多,在表面上患有相同癌症类型的患者之间也存在差异,并且能够利用多种细胞类型来增强其稳定性。因此,单一疗法的总体获益仍然有限。前沿技术现已能够进行广泛的肿瘤分析,可用于界定原发性和/或获得性免疫抵抗的肿瘤细胞内在和外在通路,本文中将其称为对当前疗法的免疫抵抗特征或特征集。我们提出,癌症可以通过免疫抵抗原型来表征,该原型由五个特征集组成,涵盖已知的免疫抵抗机制。抵抗原型可能为新的治疗策略提供信息,这些策略同时针对多个细胞轴和/或抑制机制,临床医生因此可能能够为个体患者优先选择靶向治疗组合,以提高总体疗效和结局。
Anticancer immunotherapies, such as immune checkpoint inhibitors, bispecific antibodies, and chimeric antigen receptor T cells, have improved outcomes for patients with a variety of malignancies.
However, most patients either do not initially respond or do not exhibit durable responses due to primary or adaptive/acquired immune resistance mechanisms of the tumor microenvironment. These suppressive programs are myriad, different between patients with ostensibly the same cancer type, and can harness multiple cell types to reinforce their stability.
Consequently, the overall benefit of monotherapies remains limited. Cutting-edge technologies now allow for extensive tumor profiling, which can be used to define tumor cell intrinsic and extrinsic pathways of primary and/or acquired immune resistance, herein referred to as features or feature sets of immune resistance to current therapies.
We propose that cancers can be characterized by immune resistance archetypes, comprised of five feature sets encompassing known immune resistance mechanisms. Archetypes of resistance may inform new therapeutic strategies that concurrently address multiple cell axes and/or suppressive mechanisms, and clinicians may consequently be able to prioritize targeted therapy combinations for individual patients to improve overall efficacy and outcomes.
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