CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Presetting CAR-T cells during ex vivo biomanufacturing.
Presetting CAR-T cells during ex vivo biomanufacturing.
分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。
嵌合抗原受体(CAR)-T细胞疗法已经彻底改变了血液系统恶性肿瘤的治疗。然而,它仍然面临重大障碍,包括治疗复发和实体瘤中疗效有限。效应T细胞表现出强大的细胞毒性,而中央记忆T细胞和干细胞样T细胞对于体内扩增、长期存活和持久性至关重要。通过基因工程增强CAR-T 细胞疗效和持久性的策略往往伴随着安全性风险的增加,这不仅提高了监管审批门槛,也推高了CAR-T 生产成本。相比之下,优化体外制造条件是一种更直接且实用的方法,具有快速应用于已商业批准的CAR-T 产品并改善其临床结果的潜力。本综述探讨了多种已被证明可改善T细胞记忆表型和体内细胞毒活性的因素,包括细胞因子、电解质、信号通路抑制剂、代谢调节剂和表观遗传药物。所提供的研究见解将指导CAR-T 细胞工业化生产的优化。此外,本文还讨论了选择适当条件的考量,在有效性、成本效益、安全性和监管合规之间取得平衡,同时应对该领域当前的挑战。
Chimeric antigen receptor (CAR)-T cell therapy has revolutionized the treatment of hematologic malignancies.
However, it continues to encounter significant obstacles, including treatment relapse and limited efficacy in solid tumors. While effector T cells exhibit robust cytotoxicity, central memory T cells and stem cell-like T cells are essential for in vivo expansion, long-term survival, and persistence. Strategies such as genetic engineering to enhance CAR-T cell efficacy and durability are often accompanied by increased safety risks, which not only raise regulatory approval thresholds but also escalate CAR-T production costs.
In contrast, optimizing ex vivo manufacturing conditions represents a more straightforward and practical approach, offering the potential for rapid application to commercially approved CAR-T products and enhancement of their clinical outcomes.
This review examines several factors that have been shown to improve T cell memory phenotype and in vivo cytotoxic activity, including cytokines, electrolytes, signaling pathway inhibitors, metabolic modulators, and epigenetic agents. The insights provided will guide the optimization of CAR-T cell industrial production.
Furthermore, considerations for selecting appropriate conditions are discussed, balancing effectiveness, cost-efficiency, safety, and regulatory compliance while addressing current challenges in the field.
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