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:Advances and challenges in CAR-T cell therapy for head and neck squamous cell carcinoma.
头颈部鳞状细胞癌(HNSCC)仍是最具侵袭性的恶性肿瘤之一,治疗选择有限,尤其是在复发和转移性病例中。
头颈部鳞状细胞癌(HNSCC)仍是侵袭性最强的恶性肿瘤之一,治疗选择有限,尤其是复发和转移病例。尽管手术、放疗、化疗和免疫检查点抑制剂不断进步,但由于肿瘤异质性、免疫逃逸和治疗耐药,患者生存率仍不理想。近年来,嵌合抗原受体(CAR)T细胞疗法通过基因修饰T细胞,使其靶向CD19、CD70、BCMA、EGFR和HER2等肿瘤特异性抗原,革新了血液系统肿瘤的治疗,并带来较高缓解率。其成功归因于精准抗原识别、持续免疫应答和长期免疫记忆,但细胞因子释放综合征和抗原丢失等挑战仍然存在。值得注意的是,将该疗法拓展至包括HNSCC在内的实体瘤仍面临重大困难,例如肿瘤微环境(TME)诱导的免疫抑制、抗原异质性以及CAR T细胞浸润不足。为克服这些障碍,研究者已在HNSCC中发现多种潜在CAR T细胞靶点,包括EGFR、HER2(ErbB2)、B7-H3、CD44v6、CD70、CD98和MUC1等肿瘤相关抗原(TAA)。此外,双靶向CAR T细胞、装甲型CAR以及CRISPR工程化改造等创新策略,旨在提高疗效并克服耐药。研究者还在探索将CAR T细胞与免疫检查点抑制剂(如阻断PD-1/CTLA-4)联合,以及设计耐受TGF-β的CAR T细胞,以改善治疗结局。本综述旨在阐明CAR T细胞治疗HNSCC的现状,探讨其作用机制、靶抗原、面临的挑战、新兴策略及未来治疗潜力。
Head and neck squamous cell carcinoma (HNSCC) remains among the most aggressive malignancies with limited treatment options, especially in recurrent and metastatic cases. Despite advances in surgery, radiotherapy, chemotherapy, and immune checkpoint inhibitors, survival rates remain suboptimal due to tumor heterogeneity, immune evasion, and treatment resistance. In recent years, Chimeric Antigen Receptor (CAR) T-cell therapy has revolutionized hematologic cancer treatment by genetically modifying T cells to target tumor-specific antigens like CD19, CD70, BCMA, EGFR, and HER2, leading to high remission rates. Its success is attributed to precise antigen recognition, sustained immune response, and long-term immunological memory, though challenges like cytokine release syndrome and antigen loss remain. Notably, its translation to solid tumors, including HNSCC, faces significant challenges, such as tumor microenvironment (TME)-induced immunosuppression, antigen heterogeneity, and limited CAR T-cell infiltration. To address these barriers, several tumor-associated antigens (TAAs), including EGFR, HER2 (ErbB2), B7-H3, CD44v6, CD70, CD98, and MUC1, have been identified as potential CAR T-cell targets in HNSCC. Moreover, innovative approaches, such as dual-targeted CAR T-cells, armored CARs, and CRISPR-engineered modifications, aim to enhance efficacy and overcome resistance. Notably, combination therapies integrating CAR T-cells with immune checkpoint inhibitors (e.g., PD-1/CTLA-4 blockade) and TGF- -resistant CAR T designs are being explored to improve therapeutic outcomes. This review aimed to elucidate the current landscape of CAR T-cell therapy in HNSCC, by exploring its mechanisms, targeted antigens, challenges, emerging strategies, and future therapeutic potential.
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