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 NK Cell Therapy for the Treatment of Metastatic Melanoma: Potential & Prospects.
CAR NK Cell Therapy for the Treatment of Metastatic Melanoma: Potential & Prospects.
黑色素瘤是最致命的癌症类型之一,尽管仅占皮肤癌病例的 5%,却造成了 80% 的死亡。
黑色素瘤是致死性最高的癌症之一:尽管仅占皮肤癌病例的5%,却导致80%的皮肤癌相关死亡。由于黑色素瘤异质性背后的遗传和表观遗传机制促使继发性耐药迅速形成,治疗选择仍然有限。因此,开发新疗法对改善患者结局至关重要。尽管表达嵌合抗原受体的T细胞(CAR-T)免疫疗法已在血液系统恶性肿瘤中取得多项临床成功,但其应用受到免疫介导副作用及全身毒性风险较高的限制。CAR自然杀伤(CAR-NK)细胞免疫疗法是CAR-T疗法特别有前景的替代方案,其安全性特征更有利,并可实现精细调节的细胞毒性。本综述讨论CAR-NK细胞免疫疗法的前景和潜力,涉及黑色素瘤的临床背景、NK细胞免疫生物学、阻止内源免疫细胞清除肿瘤的免疫抑制屏障,以及嵌合抗原受体的结构和设计;最后提出一系列设计创新,以期在未来研究中提高CAR-NK免疫疗法的疗效。
Melanoma is among the most lethal forms of cancer, accounting for 80% of deaths despite comprising just 5% of skin cancer cases. Treatment options remain limited due to the genetic and epigenetic mechanisms associated with melanoma heterogeneity that underlie the rapid development of secondary drug resistance. For this reason, the development of novel treatments remains paramount to the improvement of patient outcomes. Although the advent of chimeric antigen receptor-expressing T (CAR-T) cell immunotherapies has led to many clinical successes for hematological malignancies, these treatments are limited in their utility by their immune-induced side effects and a high risk of systemic toxicities. CAR natural killer (CAR-NK) cell immunotherapies are a particularly promising alternative to CAR-T cell immunotherapies, as they offer a more favorable safety profile and have the capacity for fine-tuned cytotoxic activity. In this review, the discussion of the prospects and potential of CAR-NK cell immunotherapies touches upon the clinical contexts of melanoma, the immunobiology of NK cells, the immunosuppressive barriers preventing endogenous immune cells from eliminating tumors, and the structure and design of chimeric antigen receptors, then finishes with a series of proposed design innovations that could improve the efficacy CAR-NK cell immunotherapies in future studies.
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