肿瘤细胞治疗研究
英文原题：Expanding the frontier of CAR therapy: comparative insights into CAR-T, CAR-NK, CAR-M, and CAR-DC approaches.
嵌合抗原受体（CAR）疗法在血液系统恶性肿瘤中已展现出显著的临床疗效，验证了其治疗潜力。
嵌合抗原受体（CAR）疗法在血液系统恶性肿瘤中显示出显著临床疗效，证实了其治疗潜力。然而，治疗耐药和可及性有限等挑战阻碍了其更广泛应用。为克服这些限制，研究者提出了其他CAR细胞疗法，包括CAR自然杀伤（CAR-NK）、CAR巨噬细胞（CAR-M）和CAR树突状细胞（CAR-DC）疗法。与CAR-T相比，CAR-NK在细胞因子释放综合征（CRS）和神经毒性方面安全性更高，且具有天然细胞毒性，因此是有前景的选择。尽管如此，CAR-NK疗法仍受组织浸润不足和转导效率低等问题限制。CAR-M细胞具有很强的浸润能力，且可作为抗原呈递细胞，同样具有潜力，但也面临病毒转导效率不理想的挑战。CAR-DC疗法正在快速发展，目前正积极研究。本综述总结CAR-T、CAR-NK、CAR-M和CAR-DC疗法的特征、当前临床试验、比较优势和局限。最后，我们讨论这些新兴CAR细胞疗法需要解决的关键挑战和未来前景。
Chimeric antigen receptor (CAR) therapies have demonstrated remarkable clinical efficacy in hematological malignancies, validating their therapeutic potential. However, challenges such as therapeutic resistance and limited accessibility hinder their broader application. To overcome these limitations, alternative CAR-based cell therapies, including CAR-Natural Killer (CAR-NK), CAR-macrophage (CAR-M), and CAR-dendritic cell (CAR-DC) therapies, have been proposed. Compared with CAR-T, CAR-NK cells have a higher safety profile in terms of cytokine release syndrome (CRS) and neurotoxicity, while being naturally cytotoxic, making them a promising option. Despite these advantages, CAR-NK therapy is limited by issues such as insufficient tissue infiltration and low transduction efficiency. CAR-M cells, with their potent infiltration capabilities and ability to function as antigen-presenting cells, also hold promise but face challenges related to suboptimal viral transduction efficiency. CAR-DCs are emerging as a highly promising approach and are currently undergoing active investigation. This review summarizes the profiles, current clinical trials, and comparative advantages and limitations of CAR-T, CAR-NK, CAR-M, and CAR-DC therapies. Finally, we discuss the key challenges to be addressed and the future prospects of these evolving CAR-based cell therapies.
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