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血液系统恶性肿瘤基于 TCR 的治疗:临床试验、挑战和变化

英文原题:Clinical trials, challenges, and changes in TCR-based therapeutics for hematologic malignancies.

PubMed 2024/12/16(内容时间) Expert Rev Hematol Q2 · IF 2.8(JCR 2025)

研究概要

未来,TCR-T 在血液系统恶性肿瘤中的前景将在后期临床试验和临床使用获批中得到验证。

中文摘要

引言:工程化表达抗原特异性T细胞受体(TCR)的T细胞(TCR-T)是一类有前景的免疫疗法,可用于血液系统恶性肿瘤患者。与嵌合抗原受体工程化T细胞(CAR-T)类似,TCR-T是特异性和组成明确的细胞产品。与CAR-T不同,TCR-T可识别来源于细胞内和细胞表面蛋白的靶点,并利用天然TCR信号机制的敏感性。针对不同血液系统恶性肿瘤和多种抗原的TCR-T疗法,正逐渐进入早期临床试验,更多产品处于临床前开发阶段。 综述范围:本文介绍血液系统恶性肿瘤TCR-T早期临床试验结果,并回顾该领域的挑战,包括鉴定最佳靶点、为CD8+ T细胞提供CD4+辅助,以及克服肿瘤诱导的免疫抑制;同时重点介绍近期克服这些挑战的创新方法。 专家意见:未来TCR-T治疗血液系统恶性肿瘤的潜力,将通过后期临床试验和临床使用批准得到证实。改进抗原发现方法可扩展靶点库,使TCR-T适用范围更广。合理设计的TCR-T改造(包括加入辅助受体和基因编辑)可增强其功能。融合TCR和CAR特征的新型杂合受体也将进入临床。

展开英文摘要原文

INTRODUCTION: T cells engineered to express antigen-specific T cell receptors (TCR; TCR-T) are a promising class of immunotherapeutic for patients with hematologic malignancies. Like chimeric antigen receptor-engineered T cells (CAR-T), TCR-T are cell products with defined specificity and composition. Unlike CAR-T, TCR-T can recognize targets arising both from intracellular and cell surface proteins and leverage the sensitivity of natural TCR signaling machinery. A growing number of TCR-T targeting various antigens in different hematologic malignancies are in early-phase clinical trials, and more are in preclinical development. AREAS COVERED: This review covers results from early-phase TCR-T clinical trials for hematologic malignancies. Challenges in the field are reviewed, including identifying optimal targets, engaging CD4 + help for CD8 + T cells, and overcoming tumor-induced suppression; recent innovations to overcome these challenges are also highlighted. EXPERT OPINION: In the future, TCR-T's promise for hematologic malignancies will be borne out in later-phase clinical trials and approvals for clinical use. Improved antigen discovery methods will help build the toolbox of targets needed for broadly applicable TCR-T. Rationally designed TCR-T modifications including incorporation of accessory receptors and gene editing will enhance TCR-T function. New hybrid receptors combining features of TCR and CAR will enter the clinic.

论文信息

作者
Biernacki MA、Bleakley M
单位
Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.United States
文献类型
综述 · 美国 NIH 资助研究
期刊
Expert review of hematology2025 Jan
原文标识
PubMed 39667756 · DOI 10.1080/17474086.2024.2441962