CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Genome-edited allogeneic CAR-T cells: the next generation of cancer immunotherapies.
Genome-edited allogeneic CAR-T cells: the next generation of cancer immunotherapies.
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CAR-T 细胞疗法改变了癌症免疫治疗,尤其是血液系统恶性肿瘤的治疗。然而,自体CAR-T 细胞的临床应用面临成本高和生产困难等重大挑战。源自健康供者的通用异体CAR-T 细胞是解决这些问题的一种有前景的方案。这类“现货型”疗法旨在降低CAR-T 生产的复杂性和成本。尽管基因编辑技术取得令人振奋的进展,临床试验数据也显示良好前景,但仍存在重要挑战,包括移植物抗宿主病(GVHD)、宿主抗移植物反应(HVGR)、脱靶效应、基因毒性及规模化生产。为应对这些问题,研究者正在采用锌指核酸酶(ZFN)、转录激活因子样效应物核酸酶(TALEN)、巨核酸酶、CRISPR系统、碱基编辑和先导编辑等基因组编辑技术。本综述总结通用异体CAR-T 疗法的进展,讨论关键挑战,并展望其临床应用的未来方向。
Chimeric Antigen Receptor T (CAR-T) cell therapy has revolutionized cancer immunotherapy, particularly in hematological malignancies.
However, the clinical application of autologous CAR-T cells faces significant high cost and manufacturing challenges. Universal allogeneic CAR-T cells, derived from healthy donors, represent a promising solution to these obstacles. These "off-the-shelf" therapies aim to reduce the complexity and cost of CAR-T production. Despite exciting advancements in genome-editing technologies and promising clinical trial data, significant challenges remain, including graft-versus-host disease (GVHD), Host-versus-graft reaction (HVGR), off-target effects, genotoxicity, and manufacturing scalability.
To address these concerns, genome-editing technologies such as ZFNs, TALENs, Meganucleases, CRISPR systems, base editing, and prime editing are being employed. This review summarizes the progress of universal allogeneic CAR-T cell therapies, addresses the critical challenges, and discusses the future directions for their clinical implementation.
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