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.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Reprogramming natural killer cells for cancer therapy.
Reprogramming natural killer cells for cancer therapy.
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过去十年,细胞免疫治疗领域发展迅速,尤其是嵌合抗原受体(CAR)修饰的T细胞。然而,严重治疗相关毒性和自体产品质量不稳定等挑战阻碍了CAR-T 细胞治疗的广泛应用,凸显出探索替代免疫细胞用于肿瘤靶向的必要性。在这方面,自然杀伤(NK)细胞在细胞免疫治疗中已被广泛研究,发现其发挥细胞毒性作用不受人类白细胞抗原限制,且引起移植物抗宿主病的风险较低,使其有利于开发即用型“现货”产品。使用未编辑NK细胞或重编程NK细胞的临床试验已显示出其抗肿瘤有效性的早期迹象。然而,包括体内持久性和扩增潜力有限等局限性仍然存在。为增强NK细胞的抗肿瘤功能,已探索了先进的基因编辑技术和联合方案。在本综述中,我们总结了当前抗肿瘤NK细胞治疗的临床试验,概述了重编程NK细胞的创新策略,包括在持久性、细胞毒性、迁移和对抗免疫抑制性肿瘤微环境能力方面的改进,并讨论了一些潜在的联合治疗。
The last decade has seen rapid development in the field of cellular immunotherapy, particularly in regard to chimeric antigen receptor (CAR)-modified T cells.
However, challenges, such as severe treatment-related toxicities and inconsistent quality of autologous products, have hindered the broader use of CAR-T cell therapy, highlighting the need to explore alternative immune cells for cancer targeting.
In this regard, natural killer (NK) cells have been extensively studied in cellular immunotherapy and were found to exert cytotoxic effects without being restricted by human leukocyte antigen and have a lower risk of causing graft-versus-host disease; making them favorable for the development of readily available "off-the-shelf" products. Clinical trials utilizing unedited NK cells or reprogrammed NK cells have shown early signs of their effectiveness against tumors.
However, limitations, including limited in vivo persistence and expansion potential, remained. To enhance the antitumor function of NK cells, advanced gene-editing technologies and combination approaches have been explored.
In this review, we summarize current clinical trials of antitumor NK cell therapy, provide an overview of innovative strategies for reprogramming NK cells, which include improvements in persistence, cytotoxicity, trafficking and the ability to counteract the immunosuppressive tumor microenvironment, and also discuss some potential combination therapies.
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