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:Augmenting the landscape of chimeric antigen receptor T-cell therapy.
Augmenting the landscape of chimeric antigen receptor T-cell therapy.
mRNA 引导的 CAR-T 细胞治疗是一个快速发展的领域,其成功需要利益相关者之间的协作。
重组DNA技术和活细胞基因组改造推动了细胞与基因疗法的发展,并为多种适应证带来首个可能治愈的治疗。首个CAR-T 细胞疗法于2017年获批,成为突破性创新,但目前可及国家仍有限。其普及受到自体治疗模式、认知不足、入选标准、基础设施成本、专业人员需求、复杂生产、监管挑战、疾病复发及长期随访等因素限制。本文综述促进CAR-T疗法普及的愿景与策略,以及利用mRNA CAR-T平台建设可及、可获得且可负担生态体系的方案。作者指出,mRNA引导的CAR-T疗法发展迅速,需要利益相关方协作推动其成功。
INTRODUCTION: The inception of recombinant DNA technology and live cell genomic alteration have paved the path for the excellence of cell and gene therapies and often provided the first curative treatment for many indications. The approval of the first Chimeric Antigen Receptor (CAR) T-cell therapy was one of the breakthrough innovations that became the headline in 2017. Currently, the therapy is primarily restricted to a few nations, and the market is growing at a CAGR (current annual growth rate) of 11.6% (2022-2032), as opposed to the established bio-therapeutic market at a CAGR of 15.9% (2023-2030). The limited technology democratization is attributed to its autologous nature, lack of awareness, therapy inclusion criteria, high infrastructure cost, trained personnel, complex manufacturing processes, regulatory challenges, recurrence of the disease, and long-term follow-ups. AREAS COVERED: This review discusses the vision and strategies focusing on the CAR T-cell therapy democratization with mitigation plans. Further, it also covers the strategies to leverage the mRNA-based CAR T platform for building an ecosystem to ensure availability, accessibility, and affordability to the community. EXPERT OPINION: mRNA-guided CAR T cell therapy is a rapidly growing area wherein a collaborative approach among the stakeholders is needed for its success.
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