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肿瘤通用型 CAR-T 细胞治疗:进展与挑战

英文原题:Universal CAR-T Cell Therapy for Cancer Treatment: Advances and Challenges.

查看英文原题

Universal CAR-T Cell Therapy for Cancer Treatment: Advances and Challenges.

PubMed 2025/10/22(内容时间) Oncol Res Q2 · IF 4.6(JCR 2025)

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中文摘要

本综述旨在探讨通用型CAR(UCAR)细胞疗法的发展、挑战和未来方向,将其视为自体CAR-T 癌症治疗的一种可规模化替代方案。自体CAR-T 存在生产周期长、质量不稳定和成本高等局限,推动了现货型UCAR的开发,以实现生产标准化并改善治疗可及性。目前UCAR-T 策略重点采用先进基因编辑技术,降低移植物抗宿主病和宿主抗移植物排斥风险,包括利用CRISPR-Cas9敲除T细胞受体、人白细胞抗原及CD52。除常规T细胞外,双阴性T细胞、γδT细胞和病毒特异性T细胞等也正在进行CAR工程化,以改善肿瘤靶向并尽量减少对肿瘤外组织的毒性。UCAR-T 疗法常用于急性淋巴细胞白血病、非霍奇金淋巴瘤和多发性骨髓瘤等血液系统恶性肿瘤,许多临床研究支持其疗效和安全性。实体瘤试验(如CYAD-101、CTX130)虽显示一定应答,但肿瘤异质性和T细胞耗竭等挑战仍存在。未来研究应重点优化基因编辑精准性、整合联合治疗并推进可规模化生产平台。随着靶点和细胞类型不断扩展,UCAR疗法在血液系统和实体肿瘤中均显示出前景,有望重塑癌症治疗和患者结局。

展开英文摘要原文

This review aims to explore the development, challenges, and future directions of UCAR cell therapy as a scalable alternative to autologous CAR-T for cancer treatment. Consequently, limitations of autologous CAR-T, including long production, variable quality, and cost, drive off-the-shelf UCAR development to standardize manufacturing and improve access. Current UCAR-T cell strategies focus on mitigating the risks of graft-vs. -host disease and host-vs. -graft rejection through advanced gene editing technologies, including clustered regularly interspaced short palindromic repeat-associated system Cas9-mediated knockout of the T cell receptor, human leukocyte antigen, and cluster of differentiation 52 (CD52 ) .

Beyond conventional T cells, cell types such as double-negative T cells, T cells, and virus-specific T cells are being engineered with CARs to improve tumor targeting and minimize off-tumor toxicity. UCAR-T therapy is frequently used for hematologic malignancies, including acute lymphoblastic leukemia, non-Hodgkin lymphoma, and multiple myeloma, with efficacy and safety supported by numerous clinical studies. Although trials for solid tumors (e.

g. , CYAD-101, CTX130) show modest responses, challenges such as tumor heterogeneity and T cell exhaustion remain. Future research should focus on optimizing gene editing precision, integrating combination therapies, and advancing scalable manufacturing platforms. With expanded targets and cell types, UCAR therapies show promise for both hematologic and solid tumors, reshaping cancer treatment and patient outcomes.

论文信息

作者
Lei J、Ni Z、Zhang R
单位
School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.China
文献类型
综述
期刊
Oncology research2025
原文标识
PubMed 41179303 · DOI 10.32604/or.2025.067445