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:Bispecific T-cell engagers for the recruitment of T cells in solid tumors: a literature review.
在过去十年中,基于 T 细胞的免疫疗法已发展成为一些最有前途的癌症治疗方法。
在过去十年中,基于T细胞的免疫疗法已发展成为最具前景的癌症治疗方法之一。继免疫检查点抑制剂取得成功之后,其他基于T细胞的疗法相继出现,包括CAR-T细胞和双特异性T细胞衔接器(BiTEs)。BiTEs具有独特的能力,能够在不依赖主要组织相容性复合体(MHC)限制的情况下将T细胞与肿瘤细胞交联。它们不依赖TCR特异性或CD4+/CD8+共刺激分子,从而克服了肿瘤MHC下调及低亲和力TCR结合的问题。然而,与许多其他免疫疗法一样,BiTEs在血液系统恶性肿瘤治疗之外的成功有限。用于治疗实体瘤的BiTEs仍面临挑战。胃肠道肿瘤的研究揭示了Fc毒性、短半衰期和免疫毒性等问题,促使开发了Fc沉默、半衰期延长的BiTEs,并采用人源化单链可变片段。前列腺肿瘤、肺肿瘤和恶性胶质瘤的研究分别发现了PSMA、DLL3和EGFRvIII等有前景的靶点,但也凸显了靶向非肿瘤组织毒性、BiTE特异性毒性以及肿瘤微环境难以进入或具有免疫抑制性的问题。克服这些局限性的持续研究仍是一个值得关注的有趣领域,因为BiTEs有潜力成为强大的工具,尤其是与其他免疫疗法联合使用时。
In the past decade, T-cell-based immunotherapies have grown to become some of the most promising treatments for cancer. Following the success of immune checkpoint inhibitors, other T-cell-based therapies emerged including CAR-T cells and bispecific T-cell engagers (BiTEs). BiTEs have the unique ability to crosslink T cells and tumor cells independently of major histocompatibility complex (MHC) restriction. They do not rely on TCR specificity or the CD4+/CD8+ costimulatory molecules, overcoming tumor MHC downregulation and low-affinity TCR binding. However, like many other immunotherapies, BiTEs have shown limited success beyond the treatment of hematological malignancies. BiTEs for the treatment of solid tumors still face challenges. Studies in gastrointestinal tumors have revealed Fc toxicity, short half-lives, and immunotoxicity, leading to Fc-silenced half-life extended BiTEs with humanized single-chain variable fragments. Studies in prostate tumors, lung tumors, and malignant gliomas have identified promising targets in PSMA, DLL3, and EGFRvIII, respectively, but also highlighted the problems of on-target off-tumor and BiTE-specific toxicities and inaccessible or immunosuppressive tumor microenvironments. Ongoing research to overcome these limitations remains an interesting field to follow, as BiTEs have the potential to be a powerful tool, especially when used in combination with other immunotherapies.
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