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 Cell Therapy for Hepatocellular Carcinoma: Where Do We Stand?
肝细胞癌(HCC)仍然是一个全球健康挑战,迫切需要创新的治疗策略。
肝细胞癌(HCC)仍然是一个全球性健康挑战,迫切需要创新的治疗策略。CAR-T 细胞(CAR T)疗法已成为HCC治疗的一个有前景的途径。然而,CAR T免疫疗法在HCC患者中的治疗效果受到一些主要问题的显著影响,包括肿瘤内的免疫抑制环境、抗原异质性、CAR T细胞耗竭以及on-target/off-tumor毒性的高风险。为克服这些挑战,许多正在进行的临床前和临床试验正致力于确定最佳靶抗原并解析HCC的免疫抑制微环境。此外,有限的肿瘤浸润构成了CAR T细胞疗法的一个重大障碍,应予解决。为CAR细胞设计分子靶点的持续努力凸显了采用更实用的CAR修饰细胞制造方法的重要性。本综述批判性地审视了CAR T细胞疗法治疗HCC的当前格局,阐明了HCC背景下固有免疫和适应性免疫应答的变化,确定了潜在的CAR T细胞靶点,并探索了克服固有挑战的方法。科学研究的持续进展以及多种治疗模式的融合,为未来大幅提升HCC患者的诊疗水平提供了可能。
Hepatocellular carcinoma (HCC) remains a global health challenge that urgently calls for innovative therapeutic strategies. Chimeric antigen receptor T cell (CAR T) therapy has emerged as a promising avenue for HCC treatment. However, the therapeutic efficacy of CAR T immunotherapy in HCC patients is significantly compromised by some major issues including the immunosuppressive environment within the tumor, antigen heterogeneity, CAR T cell exhaustion, and the advanced risk for on-target/off-tumor toxicity. To overcome these challenges, many ongoing preclinical and clinical trials are underway focusing on the identification of optimal target antigens and the decryption of the immunosuppressive milieu of HCC. Moreover, limited tumor infiltration constitutes a significant obstacle of CAR T cell therapy that should be addressed. The continuous effort to design molecular targets for CAR cells highlights the importance for a more practical approach for CAR-modified cell manufacturing. This review critically examines the current landscape of CAR T cell therapy for HCC, shedding light on the changes in innate and adaptive immune responses in the context of HCC, identifying potential CAR T cell targets, and exploring approaches to overcome inherent challenges. Ongoing advancements in scientific research and convergence of diverse treatment modalities offer the potential to greatly enhance HCC patients' care in the future.
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