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:A Roadmap of CAR-T-Cell Therapy in Glioblastoma: Challenges and Future Perspectives.
A Roadmap of CAR-T-Cell Therapy in Glioblastoma: Challenges and Future Perspectives.
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胶质母细胞瘤(GBM)是最常见的原发性恶性脑肿瘤,中位总生存期不足 2 年;标准治疗包括手术后联合放化疗,但死亡率接近 100%,因此亟需新的治疗策略。嵌合抗原受体(CAR)T 细胞治疗血液系统恶性肿瘤的成功,推动了 GBM CAR-T 的临床前和临床研究,但近期试验尚未取得重大成功。本文阐述阻碍 GBM CAR-T 疗效的现有挑战,包括“免疫冷”(免疫抑制)微环境、肿瘤异质性、T 细胞耗竭、局部和全身免疫抑制,以及中枢神经系统(CNS)实质固有的免疫特权。此外,文章讨论下一代 CAR-T 的开发进展,以及低强度脉冲聚焦超声等新型创新方法如何克服 GBM CAR-T 当前障碍。
Glioblastoma (GBM) is the most common primary malignant brain tumor, with a median overall survival of less than 2 years and a nearly 100% mortality rate under standard therapy that consists of surgery followed by combined radiochemotherapy.
Therefore, new therapeutic strategies are urgently needed. The success of chimeric antigen receptor (CAR) T cells in hematological cancers has prompted preclinical and clinical investigations into CAR-T-cell treatment for GBM.
However, recent trials have not demonstrated any major success.
Here, we delineate existing challenges impeding the effectiveness of CAR-T-cell therapy for GBM, encompassing the cold (immunosuppressive) microenvironment, tumor heterogeneity, T-cell exhaustion, local and systemic immunosuppression, and the immune privilege inherent to the central nervous system (CNS) parenchyma.
Additionally, we deliberate on the progress made in developing next-generation CAR-T cells and novel innovative approaches, such as low-intensity pulsed focused ultrasound, aimed at surmounting current roadblocks in GBM CAR-T-cell therapy.
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