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CAR 基础治疗的最新进展:体内 CAR 生产作为细胞性癌症治疗的革命

英文原题:State of the art in CAR-based therapy: In vivo CAR production as a revolution in cell-based cancer treatment.

查看英文原题

State of the art in CAR-based therapy: In vivo CAR production as a revolution in cell-based cancer treatment.

PubMed 2025/04/22(内容时间) Cell Oncol (Dordr) Q1 · IF 5.6(JCR 2025)

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中文摘要

嵌合抗原受体(CAR)疗法已成功治疗复发/难治性血液系统恶性肿瘤。该策略能够有效靶向肿瘤细胞。然而,尽管在临床应用中取得了积极结果,仍需克服诸多挑战。这些障碍涉及药物生产、实体瘤耐药性以及与治疗相关的副作用。由于生产问题、生产周期延长和高昂成本,部分病例在药物制备过程中被遗漏。这些挑战主要源于体外生产流程,因此重新评估该流程可减少被遗漏的患者数量。传统上,免疫细胞被采集并送往实验室;经过若干步骤后,细胞被修饰以表达 CAR 基因,然后再回输到患者体内。在体内方法中,CAR 基因被导入体内的免疫细胞。这使得治疗能够更早开始,避免药物制备中的潜在失败以及相关的高昂成本。在本综述中,我们将详细阐述利用体内 CAR 的生产和治疗过程,审视该方法的优势与挑战,并最终提出将这一治疗纳入临床实践的可行解决方案。

展开英文摘要原文

Chimeric antigen receptor (CAR) therapy has successfully treated relapsed/refractory hematological cancers. This strategy can effectively target tumor cells.

However, despite positive outcomes in clinical applications, challenges remain to overcome. These hurdles pertain to the production of the drugs, solid tumor resistance, and side effects related to the treatment. Some cases have been missed during the drug preparation due to manufacturing issues, prolonged production times, and high costs. These challenges mainly arise from the in vitro manufacturing process, so reevaluating this process could minimize the number of missed patients.

The immune cells are traditionally collected and sent to the laboratory; after several steps, the cells are modified to express the CAR gene before being injected back into the patient's body. During the in vivo method, the CAR gene is introduced to the immune cells inside the body.

This allows for treatment to begin sooner, avoiding potential failures in drug preparation and the associated high costs. In this review, we will elaborate on the production and treatment process using in vivo CAR, examine the benefits and challenges of this approach, and ultimately present the available solutions for incorporating this treatment into clinical practice.

论文信息

作者
Esmaeilzadeh A、Hadiloo K、Yaghoubi S、Makoui MH、Mostanadi P
单位
Pficell R&D Canadian Institution & Corporation, Profound Future Focused Innovative Cell and Gene Therapy, Pficell Canadian Institution and Corporation, Ontario, Canada. a46reza@zums.ac.ir.Canada
文献类型
综述
期刊
Cellular oncology (Dordrecht, Netherlands)2025 Aug
原文标识
PubMed 40261561 · DOI 10.1007/s13402-025-01056-7