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:CAR-T Therapy for the Treatment of Colorectal Cancer.
CAR-T Therapy for the Treatment of Colorectal Cancer.
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结直肠癌(CRC)是全球最常见的恶性肿瘤之一。晚期CRC预后不佳,治疗主要依赖化疗联合靶向治疗。目前,基于免疫检查点抑制剂的免疫疗法仅用于错配修复缺陷(dMMR)或微卫星高度不稳定(MSI-H)肿瘤,这类病例占晚期CRC不足10%。嵌合抗原受体(CAR)T细胞疗法是一种过继细胞疗法,通过基因改造T淋巴细胞表达嵌合抗原受体,使其识别肿瘤细胞表面抗原。CAR-T 疗法已显示治疗淋巴瘤、骨髓瘤和白血病等血液系统恶性肿瘤的疗效。
然而,因抗原异质性、CAR-T 细胞进入肿瘤区域的迁移受限以及免疫抑制性肿瘤微环境等问题,其实体瘤疗效仍有限。开发实体瘤CAR-T 疗法是未满足的临床需求,尤其是免疫检查点阻断无效的CRC。临床前研究显示,多种靶向CRC肿瘤相关抗原的CAR-T 模型在体内外均有效。尽管结果令人鼓舞,早期临床试验中CAR-T 治疗CRC的临床疗效仍有限,需考虑试验设计及抗原异质性、免疫抑制性微环境等肿瘤特征。开发创新CAR-T 模型并鉴定新抗原,可能提高CAR-T 治疗CRC患者的效果。
Colorectal cancer (CRC) is one of the most common malignancies worldwide. Advanced CRC has a poor prognosis, with treatment primarily relying on chemotherapy combined with targeted therapies. Currently, immunotherapy based on immune checkpoint inhibitors is reserved exclusively for mismatch repair-deficient (dMMR) or microsatellite instability-high (MSI-H) tumors, which represent less than 10% of advanced CRC cases.
Chimeric antigen receptor (CAR)-T cell therapy is a type of adoptive cell therapy involving modified T-lymphocytes engineered to express chimeric antigen receptors, enabling them to recognize surface antigens expressed by tumor cells. CAR-T cell therapy has demonstrated efficacy in treating hematological malignancies such as lymphoma, myeloma, and leukemia.
However, its efficacy in solid tumors remains limited due to several limitations such as antigen heterogeneity, restricted CAR-T cell trafficking into the tumor area, and the presence of an immunosuppressive tumor microenvironment. Developing novel CAR-T cell therapies for solid tumors represents an unmet need, particularly for cases where immune checkpoint blockade is ineffective, such as CRC. Preclinical studies have shown the efficacy of various CAR-T cell models targeting a wide range of tumor-associated antigens in CRC, both in vitro and in vivo .
Despite these promising results, the clinical efficacy of CAR-T cell therapy for CRC has been limited in early-phase clinical trials. Factors such as trial design or tumor characteristics, including antigen heterogeneity and the immunosuppressive microenvironment, should be considered. The development of innovative CAR-T cell models and the identification of novel antigens may improve the effectiveness of CAR-T cell therapy for CRC patients.
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