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联合 CAR-T 细胞与化疗的治疗优势

英文原题:Therapeutic advantage of combinatorial chimeric antigen receptor T cell and chemotherapies.

查看英文原题

Therapeutic advantage of combinatorial chimeric antigen receptor T cell and chemotherapies.

PubMed 2024/11/22(内容时间) Pharmacol Rev Q1 · IF 20.3(JCR 2025)

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中文摘要

嵌合抗原受体(CAR)T细胞疗法已经改变了许多血液系统恶性肿瘤患者的结局。然而,一些患者对CAR-T 细胞治疗无应答,而将CAR-T 细胞改造用于实体瘤和脑肿瘤的治疗则面临许多挑战,包括敌对的肿瘤微环境和CAR-T 细胞持久性差。

因此,单靠CAR-T 细胞疗法不太可能足以在癌症患者中实现一致、完全的肿瘤清除。CAR-T 细胞与化疗药物的联合治疗是克服这一问题的有前景的方法,因为化疗药物可以增强CAR-T 细胞以提高抗肿瘤活性,或与CAR-T 细胞协同作用以清除肿瘤。

在此,我们综述了为实现成功的CAR-T 细胞与化学药物联合治疗所做的努力。我们重点关注与已获批化疗药物的联合治疗,因为这些治疗更容易转化为临床应用,但也综述了未获批的化疗药物以及旨在揭示有前景的新型CAR-T 细胞与化学药物组合的药物筛选。

总体而言,本综述强调了CAR-T 细胞与化疗联合治疗的前景,特别关注联合治疗如何克服单一疗法所面临的挑战,并支持这一治疗策略改善癌症患者结局的潜力。意义声明:通过化疗药物联合治疗来改进目前可用的CAR-T 细胞产品,有可能大幅扩展可从这些疗法中获益的癌症类型和患者数量,而单独使用任一疗法均不足以实现肿瘤清除。

在此,我们对当前研究CAR-T 与化疗联合疗法的努力进行了全面综述,并就未来如何优化识别新的有效联合方案提供了见解。

展开英文摘要原文

Chimeric antigen receptor (CAR) T cell therapies have transformed outcomes for many patients with hematological malignancies.

However, some patients do not respond to CAR T cell treatment, and adapting CAR T cells for treatment of solid and brain tumors has been met with many challenges, including a hostile tumor microenvironment and poor CAR T cell persistence.

Thus, it is unlikely that CAR T cell therapy alone will be sufficient for consistent, complete tumor clearance across patients with cancer. Combinatorial therapies of CAR T cells and chemotherapeutics are a promising approach for overcoming this because chemotherapeutics could augment CAR T cells for improved antitumor activity or work in tandem with CAR T cells to clear tumors.

Herein, we review efforts toward achieving successful CAR T cell and chemical drug combination therapies.

We focus on combination therapies with approved chemotherapeutics because these will be more easily translated to the clinic but also review nonapproved chemotherapeutics and drug screens designed to reveal promising new CAR T cell and chemical drug combinations.

Overall, this review highlights the promise of CAR T cell and chemotherapy combinations with a specific focus on how combinatorial therapy overcomes challenges faced by either monotherapy and supports the potential of this therapeutic strategy to improve outcomes for patients with cancer.

SIGNIFICANCE STATEMENT: Improving currently available CAR T cell products via combinatorial therapy with chemotherapeutics has the potential to drastically expand the types of cancers and number of patients that could benefit from these therapies when neither alone has been sufficient to achieve tumor clearance.

Herein, we provide a thorough review of the current efforts toward studying CAR T and chemotherapy combinatorial therapies and offer perspectives on optimal ways to identify new and effective combinations moving forward.

论文信息

作者
Ward MB、Jones AB、Krenciute G
第一作者单位
Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee.
通讯作者单位
Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee. Electronic address: Giedre.Krenciute@stjude.org.
文献类型
综述
期刊
Pharmacological reviews2025 Jan
原文标识
PubMed 39952691 · DOI 10.1124/pharmrev.124.001070