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:Insights gained from single-cell analysis of chimeric antigen receptor T-cell immunotherapy in cancer.
Insights gained from single-cell analysis of chimeric antigen receptor T-cell immunotherapy in cancer.
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嵌合抗原受体(CAR)T细胞疗法的进展显著改善了复发/难治性血液系统恶性肿瘤患者的临床结局,但其发展仍受限于仅有部分患者获得临床获益。由于缺乏对体内CAR-T 细胞单细胞水平行为的认识,其临床应用进一步扩展受到阻碍。越来越多证据表明,单细胞测序技术可帮助优化受体设计、指导基因工程T细胞改造并改进CAR-T 制备条件;这些措施对于维持长期免疫监视和改善临床结局均至关重要。采用这些方法所获得的信息,也有望加深我们对决定治疗疗效和毒性的多种复杂因素的理解。本综述讨论CAR-T 免疫治疗在临床实践中失败的原因,并总结自单细胞测序技术取得里程碑式进展以来该领域的认识。我们还概述单细胞分析在CAR-T 免疫治疗中的最新应用进展,具体介绍聚焦靶抗原、CAR转基因整合、临床前研究及临床应用的单细胞研究,并讨论这些进展将如何影响CAR-T 细胞疗法的未来。
Advances in chimeric antigen receptor (CAR)-T cell therapy have significantly improved clinical outcomes of patients with relapsed or refractory hematologic malignancies.
However, progress is still hindered as clinical benefit is only available for a fraction of patients. A lack of understanding of CAR-T cell behaviors in vivo at the single-cell level impedes their more extensive application in clinical practice. Mounting evidence suggests that single-cell sequencing techniques can help perfect the receptor design, guide gene-based T cell modification, and optimize the CAR-T manufacturing conditions, and all of them are essential for long-term immunosurveillance and more favorable clinical outcomes.
The information generated by employing these methods also potentially informs our understanding of the numerous complex factors that dictate therapeutic efficacy and toxicities. In this review, we discuss the reasons why CAR-T immunotherapy fails in clinical practice and what this field has learned since the milestone of single-cell sequencing technologies.
We further outline recent advances in the application of single-cell analyses in CAR-T immunotherapy. Specifically, we provide an overview of single-cell studies focusing on target antigens, CAR-transgene integration, and preclinical research and clinical applications, and then discuss how it will affect the future of CAR-T cell therapy.
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