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推进实体瘤 CAR 细胞疗法:挑战、治疗策略和展望

英文原题:Advancing CAR-based cell therapies for solid tumours: challenges, therapeutic strategies, and perspectives.

PubMed 2025/07/07(内容时间) Mol Cancer Q1 · IF 42.2(JCR 2025)

研究概要

CAR-T 细胞疗法在血液系统恶性肿瘤中已取得显著成功,但在实体瘤中面临重大障碍。

中文摘要

嵌合抗原受体细胞疗法在血液系统恶性肿瘤中已取得显著成功,但在实体瘤中面临重大障碍。恶劣的肿瘤微环境、抗原异质性、有限的肿瘤浸润以及CAR细胞耗竭均导致疗效降低。此外,毒性、脱靶效应和生产制造方面的挑战限制了其广泛的临床采用。克服这些障碍需要多方面策略,以增强CAR细胞的持久性、迁移能力和肿瘤特异性靶向。近期在替代性细胞疗法方面的进展,如CAR-NK 细胞、CAR-巨噬细胞、γδ CAR-T细胞和CAR-自然杀伤T细胞,为改善疗效提供了有前景的途径。这些策略利用不同免疫细胞的特性来增强肿瘤识别和持久性。此外,联合治疗,包括化疗、放疗、抗体、小分子抑制剂、癌症疫苗、溶瘤病毒和多CAR细胞联合治疗,通过调节TME和改善CAR细胞功能提供了协同潜力。本综述探讨了基于CAR的细胞疗法在实体瘤中的挑战,并重点介绍了克服治疗局限的新兴策略。通过整合新型细胞平台和联合治疗方法,我们旨在为优化CAR细胞疗法以实现实体恶性肿瘤持久缓解提供见解。

展开英文摘要原文

Chimeric antigen receptor-cell therapies have demonstrated remarkable success in haematological malignancies but face significant hurdles in solid tumours. The hostile tumour microenvironment, antigen heterogeneity, limited tumour infiltration, and CAR-cell exhaustion contribute to reduced efficacy. Additionally, toxicity, off-target effects, and manufacturing challenges limit widespread clinical adoption. Overcoming these barriers requires a multifaceted approach that enhances CAR-cell persistence, trafficking, and tumour-specific targeting. Recent advancements in alternative cellular therapies, such as CAR-natural killer cells, CAR-macrophages, gamma delta CAR-T cells, and CAR-natural killer T cells, provide promising avenues for improving efficacy. These strategies leverage distinct immune cell properties to enhance tumour recognition and persistence. Furthermore, combination therapies, including chemotherapy, radiotherapy, antibodies, small molecule inhibitors, cancer vaccines, oncolytic viruses, and multi-CAR cell combination therapy, offer synergistic potential by modulating the TME and improving CAR-cell functionality. This review explores the challenges of CAR-based cellular therapies in solid tumours and highlights emerging strategies to overcome therapeutic limitations. By integrating novel cellular platforms and combination approaches, we seek to provide insights into optimising CAR-cell therapies for durable responses in solid malignancies.

论文信息

作者
Azeez SS、Yashooa RK、Smail SW、Salihi A、Ali AS、Mamand S、Janson C
第一作者单位
Department of Medical Laboratory Technology, Soran Technical College, Erbil Polytechnic University, Erbil, Kurdistan Region, 44008, Iraq.
通讯作者单位
Department of Medical Science, Respiratory Medicine, and Allergology, Uppsala University and University Hospital, Uppsala, Sweden. christer.janson@medsci.uu.se.Sweden
文献类型
综述
期刊
Molecular cancer2025 Jul 7
原文标识
PubMed 40624498 · DOI 10.1186/s12943-025-02386-8