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:Emerging Cancer Immunotherapies: Cutting-Edge Advances and Innovations in Development.
Emerging Cancer Immunotherapies: Cutting-Edge Advances and Innovations in Development.
生物疗法的兴起彻底改变了肿瘤学,免疫疗法通过黑色素瘤和B-ALL的CAR-T细胞疗法等突破引领了这一变革。
生物疗法的兴起彻底改变了肿瘤学领域,其中免疫疗法走在前沿,通过CAR-T细胞疗法治疗黑色素瘤和B-ALL等突破性进展引领潮流。经过改造的双特异性抗体和CAR-T细胞正在进一步开发以提高其疗效。然而,CAR-T细胞疗法目前依赖于昂贵的体外制造过程,亟需替代策略来克服这一瓶颈。靶向体内病毒转导提供了一条有前景的途径,但仍未得到充分优化。此外,新型方法正在涌现,例如通过体内疫苗增强CAR-T细胞以强化抗肿瘤免疫应答,以及基于树突状细胞的疫苗正在研究中。除CAR-T细胞之外,mRNA治疗代表了另一条有前景的途径。利用脂质纳米颗粒(LNPs)靶向递送DNA/RNA展现出潜力,因为LNPs可以被导向T细胞。此外,CRISPR编辑已证明能够精确编辑基因组,增强合成T细胞的效应功能和持久性。包装Cas9的包膜递送载体靶向修饰T细胞,提供了一种无病毒的安全有效分子释放方法。尽管该平台仍依赖体外转导,但使用来自健康供体或诱导多能干细胞的细胞可以降低成本、简化制造,并将治疗扩展至T细胞质量低的患者。异体CAR-T细胞在癌症中的应用因其降低成本和扩大可及性的潜力而受到关注。本综述强调了提高免疫疗法选择性和疗效的关键策略,为更精准、更成功地抗击癌症铺平了道路。
The rise in biological therapies has revolutionized oncology, with immunotherapy leading the charge through breakthroughs such as CAR-T cell therapy for melanoma and B-ALL. Modified bispecific antibodies and CAR-T cells are being developed to enhance their effectiveness further. However, CAR-T cell therapy currently relies on a costly ex vivo manufacturing process, necessitating alternative strategies to overcome this bottleneck. Targeted in vivo viral transduction offers a promising avenue but remains under-optimized. Additionally, novel approaches are emerging, such as in vivo vaccine boosting of CAR-T cells to strengthen the immune response against tumors, and dendritic cell-based vaccines are under investigation. Beyond CAR-T cells, mRNA therapeutics represent another promising avenue. Targeted delivery of DNA/RNA using lipid nanoparticles (LNPs) shows potential, as LNPs can be directed to T cells. Moreover, CRISPR editing has demonstrated the ability to precisely edit the genome, enhancing the effector function and persistence of synthetic T cells. Enveloped delivery vehicles packaging Cas9 directed to modified T cells offer a virus-free method for safe and effective molecule release. While this platform still relies on ex vivo transduction, using cells from healthy donors or induced pluripotent stem cells can reduce costs, simplify manufacturing, and expand treatment to patients with low-quality T cells. The use of allogeneic CAR-T cells in cancer has gained attraction for its potential to lower costs and broaden accessibility. This review emphasizes critical strategies for improving the selectivity and efficacy of immunotherapies, paving the way for a more targeted and successful fight against cancer.
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