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结直肠癌过继性细胞治疗:CAR-T 细胞的进展

英文原题:Adoptive cell therapy in colorectal cancer: Advances in chimeric antigen receptor T cells.

查看英文原题

Adoptive cell therapy in colorectal cancer: Advances in chimeric antigen receptor T cells.

PubMed 2025/07/15(内容时间) World J Gastrointest Oncol Q3 · IF 2.7(JCR 2025)

研究概要

结直肠癌(CRC)是全球第三大常见癌症,其治疗仍面临重大挑战,尤其是在晚期和转移阶段。

中文摘要

结直肠癌(CRC)是全球第三大常见癌症,在晚期和转移性阶段仍是重大治疗挑战。当前标准治疗疗效有限,凸显了对创新策略的迫切需求。过继细胞治疗(ACT)通过对免疫细胞进行体外扩增或基因工程改造,是增强抗肿瘤免疫应答的一种有前景的方法。关键的 ACT 模式包括嵌合抗原受体(CAR)T 细胞、TIL(肿瘤浸润淋巴细胞)和 T 细胞受体(TCR)工程化 T 细胞。CAR-T 细胞治疗已在血液系统恶性肿瘤中显示出成功,但在 CRC 等实体瘤中面临重大挑战。这些挑战包括抗原异质性、免疫抑制性肿瘤微环境、on-target off-tumor 毒性等因素。为应对这些局限性,正在积极探索联合策略,如免疫检查点抑制剂、细胞因子以及 CRISPR/Cas9 等先进基因编辑工具。这些策略旨在增强 CAR-T 细胞特异性、提高对免疫抑制信号的抵抗能力,并优化体内功能。本综述总结了针对 CRC 的 ACT 方法,重点关注 CAR-T 治疗。文中简要介绍了 TIL 和 TCR-T 细胞,同时强调 CAR-T 治疗在实体瘤中面临的主要挑战,并讨论改善治疗结局的潜在策略。

展开英文摘要原文

Colorectal cancer (CRC) is the third most common cancer worldwide and remains a major treatment challenge, particularly in advanced and metastatic stages. Current standard treatments have limited efficacy, underscoring the urgent need for innovative strategies. Adoptive cell therapy (ACT), which involves in vitro expansion or genetic engineering of immune cells, is a promising approach to bolster anti-tumor immune responses. Key ACT modalities include chimeric antigen receptor (CAR) T cells, tumor-infiltrating lymphocytes (TILs), and T cell receptor (TCR)-engineered T cells. CAR-T cell therapy has shown success in hematological malignancies but faces significant challenges in solid tumors like CRC. These challenges include antigen heterogeneity, an immunosuppressive tumor microenvironment, on-target off-tumor toxicity, among other factors. To address these limitations, combinatorial approaches, such as immune checkpoint inhibitors, cytokines, and advanced gene-editing tools like CRISPR/Cas9, are being actively explored. These strategies aim to enhance CAR-T cell specificity, improve resistance to immunosuppressive signals, and optimize in vivo functionality. This review summarizes ACT approaches for CRC, with a focus on CAR-T therapy. It briefly introduces TILs and TCR-T cells, while emphasizing the major challenges faced by CAR-T therapy in solid tumors and discusses potential strategies to improve therapeutic outcomes.

论文信息

作者
Chen MY、Wang C、Wang YG、Shi M
第一作者单位
Department of Gastroenterology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China.China
通讯作者单位
Department of Gastroenterology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China. sm1790@shtrhospital.com.China
文献类型
综述
期刊
World journal of gastrointestinal oncology2025 Jul 15
原文标识
PubMed 40697242 · DOI 10.4251/wjgo.v17.i7.106723