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 Cells in Glioblastoma-Current Concepts and Promising Future.
Chimeric Antigen Receptor T Cells in Glioblastoma-Current Concepts and Promising Future.
GBM患者的中位总生存期为15个月,鉴于这一毁灭性的预后,亟需改进治疗方法。
胶质母细胞瘤(GBM)是一种高度侵袭性的原发性脑肿瘤,对治疗在很大程度上难治,因此几乎总会复发。GBM 患者的中位 OS 为 15 个月,鉴于这一毁灭性的预后,亟需改进治疗。目前正在 GBM 中测试的治疗方法之一是嵌合抗原受体(CAR)-T 细胞疗法。CAR-T 细胞是经过基因改造的 T 细胞,被重新定向以高度特异性的方式消除肿瘤细胞。CAR-T 细胞疗法在 GBM 等实体瘤中面临若干挑战,包括受限的肿瘤组织迁移和穿透、高度免疫抑制的肿瘤微环境(TME),以及异质性抗原表达和抗原丢失。此外,CAR-T 细胞在安全性、毒性以及制造工艺方面存在局限性。迄今为止,针对 GBM 中多个靶抗原的 CAR-T 细胞,包括 IL-13R 2、EGFRvIII、HER2 和 EphA2,已在临床前和临床研究中进行了测试。这些研究表明,CAR-T 细胞疗法是 GBM 中一种可行的选择,至少具有短暂缓解和可接受的副作用。在疗效、灵活性和安全性方面对 CAR-T 细胞进行进一步改进,可能使其成为 GBM 中有前景的治疗选择。
Glioblastoma (GBM) is a highly aggressive primary brain tumor that is largely refractory to treatment and, therefore, invariably relapses. GBM patients have a median overall survival of 15 months and, given this devastating prognosis, there is a high need for therapy improvement. One of the therapeutic approaches currently tested in GBM is chimeric antigen receptor (CAR)-T cell therapy. CAR-T cells are genetically altered T cells that are redirected to eliminate tumor cells in a highly specific manner. There are several challenges to CAR-T cell therapy in solid tumors such as GBM, including restricted trafficking and penetration of tumor tissue, a highly immunosuppressive tumor microenvironment (TME), as well as heterogeneous antigen expression and antigen loss. In addition, CAR-T cells have limitations concerning safety, toxicity, and the manufacturing process. To date, CAR-T cells directed against several target antigens in GBM including interleukin-13 receptor alpha 2 (IL-13R 2), epidermal growth factor receptor variant III (EGFRvIII), human epidermal growth factor receptor 2 (HER2), and ephrin type-A receptor 2 (EphA2) have been tested in preclinical and clinical studies. These studies demonstrated that CAR-T cell therapy is a feasible option in GBM with at least transient responses and acceptable adverse effects. Further improvements in CAR-T cells regarding their efficacy, flexibility, and safety could render them a promising therapy option in GBM.
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