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实体瘤中的 CAR-T 细胞:挑战与突破

英文原题:CAR-T cells in solid tumors: Challenges and breakthroughs.

PubMed 2025/09/12(内容时间) Cell Rep Med Q1 · IF 14(JCR 2025)

研究概要

嵌合抗原受体(CAR)-T细胞疗法已经彻底改变了血液系统恶性肿瘤的治疗,但其在实体瘤中的疗效受到若干挑战的限制。

中文摘要

嵌合抗原受体(CAR)-T细胞疗法已经彻底改变了血液系统恶性肿瘤的治疗,但其在实体瘤中的疗效受到若干挑战的限制。关键障碍包括CAR-T细胞向肿瘤的运输不足、扩增和持久性有限、由于抗原丢失或异质性导致的肿瘤复发,以及抑制CAR-T细胞功能的免疫抑制性肿瘤微环境(TME)。在这篇综述中,我们讨论了近期晚期实体瘤成功临床试验的见解,并重点介绍了整合合成生物学和基因工程的前沿策略,以增强CAR-T细胞的适应性、效力和持久性,激活宿主免疫,重编程TME,并实现多抗原靶向。我们审视了当前用于评估CAR-T细胞疗法疗效和安全性的临床前模型的优缺点,包括免疫缺陷小鼠中的人源异种移植以及人源化或同基因模型。下一代CAR-T细胞疗法所采用的一系列前沿方法有望改变实体瘤的治疗格局。

展开英文摘要原文

Chimeric antigen receptor (CAR)-T cell therapy has revolutionized the treatment of hematologic malignancies, but its efficacy in solid tumors is limited by several challenges. Key obstacles include insufficient CAR-T cell trafficking to tumors, limited expansion and persistence, tumor relapse due to antigen loss or heterogeneity, and an immunosuppressive tumor microenvironment (TME) that dampens CAR-T cell functions. In this review, we discuss insights from recent successful clinical trials in advanced solid tumors and highlight groundbreaking strategies integrating synthetic biology and gene engineering to enhance CAR-T cell fitness, potency, and persistence, activate host immunity, reprogram the TME, and enable multi-antigen targeting. We examine strengths and weaknesses of current preclinical models for assessing the efficacy and safety of CAR-T cell therapies, including human xenografts in immunodeficient mice and humanized or syngeneic models. The array of cutting-edge approaches employed in next-generation CAR-T cell therapies is expected to transform the treatment landscape of solid tumors.

论文信息

作者
Escobar G、Berger TR、Maus MV
第一作者单位
Krantz Family Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Cellular Immunotherapy Program, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA.United States
通讯作者单位
Krantz Family Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Cellular Immunotherapy Program, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: mvmaus@mgh.harvard.edu.United States
文献类型
综述
期刊
Cell reports. Medicine2025 Nov 18
原文标识
PubMed 40945517 · DOI 10.1016/j.xcrm.2025.102353