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:Review of Adoptive Cellular Therapies for the Treatment of Sarcoma.
肉瘤是一组异质性恶性肿瘤,治疗选择有限,尤其是在转移性情况下。
肉瘤是一组异质性较强的恶性肿瘤,治疗选择有限,转移性疾病尤为如此。TIL(肿瘤浸润淋巴细胞)疗法、嵌合抗原受体(CAR)T细胞疗法及T细胞受体(TCR)基因修饰T细胞疗法等过继细胞疗法(ACT),为这些难治肿瘤提供了有前景的新途径。TIL疗法在黑色素瘤和骨髓瘤中已显示早期疗效,相关试验正在探索其在肉瘤中的作用。靶向HER2、GD2和B7-H3的CAR-T策略正在开发,但肿瘤微环境介导的耐药和抗原逃逸仍是重要挑战。靶向MAGE-A4和NY-ESO-1的工程化TCR在滑膜肉瘤(SS)及黏液样/圆形细胞脂肪肉瘤(MRCLS)中显示有希望的临床结果,并促成afamitresgene autoleucel(afami-cel)和letetresgene autoleucel(lete-cel)近期获美国食品药品监督管理局批准。尽管初步数据令人鼓舞,ACT的实施仍受抗原特异性有限、瘤外毒性、免疫逃逸和制造规模化等因素限制。未来研究将聚焦优化淋巴细胞清除方案、减轻毒性、增强体内持续性,以及将ACT与其他治疗药物联合。随着临床试验扩大,ACT有望通过为既往难治性疾病提供持久、靶向疗法,改变肉瘤治疗格局。
Sarcomas are a heterogeneous group of malignancies with limited therapeutic options, particularly in the metastatic setting. Adoptive cellular therapies (ACTs), including tumor-infiltrating lymphocyte (TIL) therapy, chimeric antigen receptor (CAR) T-cell therapy, and T-cell receptor (TCR) gene-modified T-cell therapy, offer promising novel approaches for these refractory tumors. TIL-based therapy has demonstrated early efficacy in melanoma and myeloma, with ongoing trials exploring its role in sarcoma. CAR T-cell strategies targeting HER2, GD2, and B7-H3 antigens are in development, though challenges such as tumor microenvironment-mediated resistance and antigen escape remain significant. Engineered TCRs, particularly those targeting MAGE-A4 and NY-ESO-1, have shown promising clinical results in synovial sarcoma (SS) and myxoid/round cell liposarcoma (MRCLS), leading to the recent FDA approval of afamitresgene autoleucel (afami-cel) and letetresgene autoleucel (lete-cel). Despite encouraging preliminary data, ACT implementation faces barriers including limited antigen specificity, off-tumor toxicity, immune evasion, and manufacturing scalability. Future research will focus on optimizing lymphodepleting regimens, mitigating toxicity, enhancing in vivo persistence, and combining ACT with other therapeutic agents. As clinical trials expand, ACT holds the potential to revolutionize sarcoma treatment by offering durable, targeted therapies for previously refractory disease.
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