肿瘤局部免疫调节：工程化 CAR-T 细胞治疗实体恶性肿瘤的关键进展

Chimeric antigen receptor (CAR)-T cell therapy, despite revolutionizing hematological malignancies, remains limited in solid tumors due to immunosuppressive microenvironments and systemic toxicities from combination immunotherapies. Recent engineering innovations demonstrate that physically linking anti-PD-L1 antibodies to interleukin-12 within CAR-T cells creates tumor-localized immunomodulation, concentrating therapeutic activity at PD-L1-positive sites while minimizing systemic exposure. In preclinical models, PD-L1-binding IL-12 fusion proteins achieved superior antitumor responses (100 vs. 50% complete responses) compared to non-binding controls, with significantly reduced inflammatory toxicity.

Spatial proteomic analysis revealed comprehensive tumor microenvironment remodeling including enhanced CD8+ T cell infiltration and reduced immunosuppressive myeloid populations. Validation in human CAR-T cells targeting TAG72-positive ovarian cancer confirmed appropriate PD-L1 binding and enhanced cytotoxicity.

This rational engineering strategy addresses multiple barriers simultaneously through molecular sequestration, offering a promising platform applicable to alternative checkpoint-cytokine combinations and other cellular therapeutics. Clinical translation represents a critical next step for extending CAR-T efficacy to solid malignancies.