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革新免疫治疗:CAR-T 细胞工程的下一个前沿

英文原题:Revolutionizing immunotherapy: The next frontier in CAR T-cell engineering.

PubMed 2025/04/28(内容时间) Crit Rev Oncol Hematol Q1 · IF 6.2(JCR 2025)

研究概要

嵌合抗原受体(CAR)T 细胞疗法已成为一种突破性的免疫疗法,为癌症治疗带来了新希望,尤其是在血液系统恶性肿瘤中。

中文摘要

嵌合抗原受体(CAR)T细胞疗法是一项突破性免疫疗法,改变了癌症治疗,尤其为血液系统恶性肿瘤治疗带来新希望。本综述介绍CAR-T细胞疗法的发展历程,从奠定基础的第一代设计到整合复杂合成生物学的先进第五代CAR。每一代CAR均引入关键改进,如加入共刺激结构域、双重信号通路及细胞因子释放机制,以增强T细胞活化、持续性和疗效。CAR-T细胞疗法治疗急性淋巴细胞白血病和弥漫性大B细胞淋巴瘤等癌症已取得显著成功,多种疗法获监管批准。然而,因免疫抑制性肿瘤微环境和抗原异质性等因素,靶向实体瘤仍具挑战。目前临床试验和研究聚焦于通过新一代CAR设计、新抗原靶点及联合治疗克服这些障碍。本综述强调近期进展、新兴靶点及CAR-T细胞疗法改变癌症治疗的潜力,有望推动更有效、个体化的治疗方式。

展开英文摘要原文

Chimeric Antigen Receptor (CAR) T-cell therapy has emerged as a groundbreaking immunotherapy, offering new hope for cancer treatment, particularly in hematologic malignancies. This review explores the development of CAR T-cell therapy from its first-generation design, which laid the foundational structure, to advanced fifth-generation CARs that integrate sophisticated synthetic biology. Each generation of CARs has introduced critical improvements, such as the incorporation of costimulatory domains, dual signaling pathways, and cytokine release mechanisms to enhance T-cell activation, persistence, and efficacy. Current applications of CAR T-cell therapy have seen significant success in treating cancers like acute lymphoblastic leukemia and diffuse large B-cell lymphoma, with several therapies gaining regulatory approval. However, challenges persist in targeting solid tumors due to the immunosuppressive tumor microenvironment and antigen heterogeneity. Ongoing clinical trials and research are focused on overcoming these barriers through next-generation CAR designs, novel antigen targets, and combination therapies. The review highlights recent advancements, emerging targets, and the potential of CAR T-cell therapy to revolutionize cancer treatment, paving the way for more effective and personalized approaches.

论文信息

作者
Suchiita A、Sonkar SC
第一作者单位
Maulana Azad Medical College, New Delhi, India. Electronic address: anuupamasuchiita@gmail.com.India
通讯作者单位
Multidisciplinary Research Unit (MRU), Maulana Azad Medical College (MAMC) and Associated Hospitals, New Delhi 110002, India; Delhi School of Public Health, Institute of Eminence, University of Delhi, Delhi 110007, India. Electronic address: drscsonkar@gmail.com.India
文献类型
综述
期刊
Critical reviews in oncology/hematology2025 Jul
原文标识
PubMed 40306469 · DOI 10.1016/j.critrevonc.2025.104751