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:Allogeneic chimeric antigen receptor T cells for children with relapsed/refractory B-cell precursor acute lymphoblastic leukemia.
Allogeneic chimeric antigen receptor T cells for children with relapsed/refractory B-cell precursor acute lymphoblastic leukemia.
在过去十年中,嵌合抗原受体(CAR)T 细胞疗法已成为一种突破性的癌症疗法。
过去十年,嵌合抗原受体(CAR)T 细胞疗法已成为癌症治疗中的突破性疗法。关键性试验和真实世界研究均报告了其治疗 B 细胞淋巴增殖性疾病及多发性骨髓瘤的显著结局。传统上,CAR 产品由患者自体 T 细胞制备。然而,该方法存在若干缺点,包括制造延迟、依赖患者 T 细胞的功能状态(疾病及既往治疗均可能损害其功能),以及产品受到白血病原始细胞污染。异基因 CAR 细胞产品的开发提供了有前景的替代方案,有望制备更高效的药物产品,并可使用同种异体反应潜能极低、且能通过其固有受体(如NK 细胞、T 细胞和细胞因子诱导杀伤细胞)发挥显著 CAR 非依赖性抗肿瘤作用的效应细胞。此外,基因编辑工具的近期进展有望克服异基因 CAR T 细胞产品的主要挑战——移植物抗宿主病和宿主异体排斥——从而制备通用型现货产品。本综述总结当前基于异基因 CAR T 细胞及其他效应细胞的临床前和临床策略;这些方法为多价靶向和优化抗肿瘤活性带来了令人振奋的机遇。
Chimeric antigen receptor (CAR) T-cell therapy has emerged as a breakthrough cancer therapy over the past decade. Remarkable outcomes in B-cell lymphoproliferative disorders and multiple myeloma have been reported in both pivotal trials and real-word studies. Traditionally, the use of a patient's own (autologous) T cells to manufacture CAR products has been the standard practice. Nevertheless, this approach has some drawbacks, including manufacturing delays, dependence on the functional fitness of the patient's T cells, which can be compromised by both the disease and prior therapies, and contamination of the product with blasts. A promising alternative is offered by the development of allogeneic CAR-cell products. This approach has the potential to yield more efficient drug products and enables the use of effector cells with negligible alloreactive potential and a significant CAR-independent antitumor activity through their innate receptors (i.e., natural killer cells, T cells and cytokine induced killer cells). In addition, recent advances in genome editing tools offer the potential to overcome the primary challenges associated with allogeneic CAR T-cell products, namely graft-versus-host disease and host allo-rejection, generating universal, off-the-shelf products. In this review, we summarize the current pre-clinical and clinical approaches based on allogeneic CAR T cells, as well as on alternative effector cells, which represent exciting opportunities for multivalent approaches and optimized antitumor activity.
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