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:Next-Generation CAR-T and TCR-T Cell Therapies for Solid Tumors: Innovations, Challenges, and Global Development Trends.
Next-Generation CAR-T and TCR-T Cell Therapies for Solid Tumors: Innovations, Challenges, and Global Development Trends.
嵌合抗原受体(CAR)-T和T细胞受体(TCR)工程化T细胞(TCR-T)疗法已经彻底改变了血液系统恶性肿瘤的治疗;然而,它们在实体瘤中的应用仍然是一个艰巨的挑战。
嵌合抗原受体(CAR)-T 和 T 细胞受体(TCR)工程化 T 细胞(TCR-T)疗法已经彻底改变了血液系统恶性肿瘤的治疗;然而,它们在实体瘤中的应用仍然是一项艰巨的挑战。免疫抑制性肿瘤微环境、抗原异质性以及生产制造的复杂性限制了这些治疗方式的临床疗效和可扩展性。本综述对当前针对实体瘤的 CAR-T 和 TCR-T 细胞疗法的临床开发策略进行了全面分析。在此,我们讨论了近期的突破,并强调了 TCR-T 细胞疗法的潜力。此外,还探讨了增强 CAR-T 细胞在实体瘤中功能的创新方法(例如,体内工程化;诱导多能干细胞来源的异体 CAR-T 细胞;装甲化 CAR 构建体;双抗原靶向;以及与检查点抑制剂、化疗、放疗和溶瘤病毒的联合方案)。我们还展示了全球专利活动的趋势,揭示 CAR-T 和 TCR-T 相关创新的显著加速,其中美国和中国在申请量方面处于领先地位。该领域日益以学术界和产业界之间的多学科协作为特征,推动下一代平台的发展,包括基于信使 RNA 的疗法和现货型细胞疗法。尽管尚无 CAR-T 产品获批用于实体瘤,但这些发现凸显了过继细胞疗法不断加快的发展势头和转化前景。解决实体瘤独特的生物学和物流挑战,对于充分实现这些变革性免疫疗法的潜力至关重要。
Chimeric antigen receptor (CAR)-T and T-cell receptor (TCR)-engineered T-cell (TCR-T) therapies have revolutionized the treatment of hematological malignancies; however, their application to solid tumors remains a formidable challenge. The immunosuppressive tumor microenvironment, antigen heterogeneity, and manufacturing complexity limit the clinical efficacy and scalability of these treatment modalities. This review provides a comprehensive analysis of the current clinical development strategies for CAR-T and TCR-T cell therapies for solid tumors. Herein, we discuss recent breakthroughs and highlight the potential of TCR-T cell therapy. Furthermore, innovative approaches for enhancing CAR-T cell function in solid tumors (e.g., in vivo engineering; induced pluripotent stem cell-derived allogeneic CAR-T cells; armored CAR constructs; dual-antigen targeting; and combination regimens with checkpoint inhibitors, chemotherapy, radiotherapy, and oncolytic viruses) are explored. We also present trends in global patent activity, revealing a marked acceleration in CAR-T- and TCR-T-related innovations, with the United States and China leading with respect to application volumes. This field is increasingly characterized by multidisciplinary collaborations between academia and industry, driving the development of next-generation platforms, including messenger RNA-based and off-the-shelf cell therapies. Although no CAR-T product has been approved for solid tumors, these findings underscore the accelerating momentum and translational promise of adoptive cell therapies. Addressing the unique biological and logistical challenges of solid tumors is essential for realizing the full potential of these transformative immunotherapies.
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