为肝细胞癌武装 GPC3 CAR T 细胞:多少才足够,下一步是什么?
Armouring GPC3 CAR T cells for hepatocellular carcinoma: how much is enough and what comes next?
英文原题:Gene Therapy Strategies for Hepatocellular Carcinoma (HCC): Current Landscape and Future Directions.
目前治疗晚期HCC的方案包括免疫治疗或酪氨酸激酶抑制剂(TKIs)的联合治疗,其生存获益仅为约2年。
肝脏是体内主要的代谢器官,负责代谢营养物质和药物。晚期肝病导致肝脏代谢功能受损。这些疾病通常难以用药物治疗,因为肝脏无法生成有效的药物代谢产物和/或无法适当地灭活药物,导致药物诱导的高毒性,进而降低患者依从性。肝细胞癌(HCC)是一种在纤维化/肝硬化肝脏上发生的疾病,大多在晚期才被诊断。目前治疗晚期HCC的方案包括免疫治疗或酪氨酸激酶抑制剂(TKIs)的联合治疗,其生存获益仅为约2年。此外,免疫治疗仅对27%的HCC患者有效,而接受TKIs治疗的患者无一例外地在6个月内产生耐药性。在这种情况下,基因治疗作为一种替代方法,可能为HCC患者带来显著获益。尽管针对HCC或其他肝脏疾病的基因治疗方法尚未获得美国食品药品监督管理局(FDA)的批准,但多年来该领域已取得重大进展。在这篇综述文章中,我们重点介绍了最新文献,这些文献展示了基因治疗在管理HCC患者、延长生存获益和提供改善生活质量方面的前景。
The liver is the primary metabolic organ in the body, metabolizing nutrients and drugs. Advanced liver diseases result in compromised metabolic function of the liver. These diseases are often difficult to treat with drugs because of inability of the liver to generate effective drug metabolites and/or to properly inactivate the drugs resulting in high drug-induced toxicity with subsequent reduced patient compliance. Hepatocellular carcinoma (HCC) is a disease that develops on a fibrotic/cirrhotic liver and is mostly diagnosed at an advanced stage. Current protocol for treating advanced HCC includes a combination of immunotherapy or tyrosine kinase inhibitors (TKIs), which provides a survival benefit of only ~2 years. In addition, immunotherapy is effective in only 27% of HCC patients and patients treated with TKIs invariably develop drug resistance within 6 months. In this scenario gene therapy serves as an alternative approach that might bring significant benefits to HCC patients. Although gene therapy approaches for HCC or other liver diseases have yet to obtain approval from the Food and Drug Administration (FDA), a significant advancement has been made over the years in this field. In this review article, we highlight very recent literature showing the promise of gene therapy in managing HCC patients, extending survival benefits and providing improved quality of life.
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