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:CAR T-cells for pediatric solid tumors: where to go from here?
CAR T-cells for pediatric solid tumors: where to go from here?
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尽管嵌合抗原受体(CAR)T 细胞在 B 细胞恶性肿瘤和多发性骨髓瘤患者中取得了巨大成功,但其对大多数实体瘤的疗效仍然有限。
尽管嵌合抗原受体(CAR)T细胞在B细胞恶性肿瘤和多发性骨髓瘤患者中取得了巨大成功,但其对大多数实体瘤的疗效仍然有限。尤其是在儿科人群中,由于伦理原因,治疗前和治疗后活检很少进行,因此,对于肿瘤微环境中肿瘤细胞排除效应细胞并吸引免疫抑制细胞的机制,我们的理解仍然非常有限。尽管如此,基于已知的原理,当前的T细胞工程已经利用了其中一些过程,并创建了更有效的CAR-T 细胞。最近新肿瘤胎儿抗原的发现以及CAR设计方面的进展,扩大了用于治疗开发的候选抗原的潜在库。增强CAR-T 细胞最有前景的方法包括新型CAR门控策略、在不增强全身毒性的情况下向TME递送细胞因子的创造性方法,以及劫持肿瘤的趋化因子轴用于迁移目的。通过这些新的修饰,CAR-T 细胞发展时代的下一步将是对这些有前景的临床前发现进行临床验证。
Despite the great success that chimeric antigen receptor (CAR) T-cells have had in patients with B-cell malignancies and multiple myeloma, they continue to have limited efficacy against most solid tumors. Especially in the pediatric population, pre- and post-treatment biopsies are rarely performed due to ethical reasons, and thus, our understanding is still very limited regarding the mechanisms in the tumor microenvironment by which tumor cells exclude effectors and attract immune-suppressive cells. Nevertheless, based on the principles that are known, current T-cell engineering has leveraged some of these processes and created more potent CAR T-cells. The recent discovery of new oncofetal antigens and progress made in CAR design have expanded the potential pool of candidate antigens for therapeutic development. The most promising approaches to enhance CAR T-cells are novel CAR gating strategies, creative ways of cytokine delivery to the TME without enhancing systemic toxicity, and hijacking the chemokine axis of tumors for migratory purposes. With these new modifications, the next step in the era of CAR T-cell development will be the clinical validation of these promising preclinical findings.
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