决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Current Developments of CAR-T and CAR-NK Cell Therapies for Ovarian Cancer.
卵巢癌(OC)仍是最致命的妇科恶性肿瘤,其特征为诊断晚、肿瘤异质性和化疗耐药,导致生存率低。
卵巢癌(OC)仍是致死率最高的妇科恶性肿瘤,其特点包括诊断较晚、肿瘤异质性和化疗耐药,导致生存率较低。本综述全面探讨嵌合抗原受体(CAR)T细胞和CAR自然杀伤(NK)细胞疗法作为OC新兴免疫疗法的潜力。综述涉及多种肿瘤相关抗原,包括叶酸受体α(FRα)、间皮素(MSLN)、HER2、EpCAM、MUC16、Tn糖肽、TAG-72和LGR5;这些靶点在OC中表达升高,并在临床前研究和早期临床试验中显示出可诱导肿瘤消退的潜力,且不受MHC限制。CAR-T细胞在临床前模型中表现出显著抗肿瘤细胞毒性,但用于OC等实体瘤仍面临免疫抑制性肿瘤微环境、抗原逃逸、细胞因子释放综合征和神经毒性等挑战。CAR-NK细胞可能具有毒性较低、可现货供应以及对异质性肿瘤有效等优势,可作为有前景的补充策略。本综述还讨论剂量方案,以及与免疫检查点抑制剂、化疗和放疗联合的策略,并比较不同组织学亚型的应答。结合正在开展的早期临床试验和CRISPR编辑、双靶向等创新方法,综述总结了CAR疗法研发进展与挑战,强调其潜力的同时指出仍需进一步研究以确立其在OC中的临床疗效。
Ovarian cancer (OC) remains the deadliest gynecological malignancy, characterized by late diagnosis, tumor heterogeneity, and chemotherapy resistance, contributing to poor survival rates. This comprehensive review explores the potential of chimeric antigen receptor (CAR)-T and CAR-natural killer (NK) cell therapies as emerging immunotherapies for OC. We examine key tumor-associated antigens, including folate receptor alpha (FR ), mesothelin (MSLN), HER2, EpCAM, MUC16, Tn-glycopeptide, TAG-72, and LGR5, which are overexpressed in OC and have shown promise in preclinical studies and early clinical trials for inducing tumor regression without MHC restrictions. While CAR-T cells have demonstrated significant antitumor cytotoxicity in preclinical models, their application in solid tumors like OC faces challenges, including immunosuppressive tumor microenvironments, antigen escape, cytokine release syndrome, and neurotoxicity. CAR-NK cells offer potential advantages, such as reduced toxicity, off-the-shelf availability, and efficacy against heterogeneous tumors, making them a promising complementary approach. This review discusses current research on dosing regimens and combination strategies involving checkpoint inhibitors, chemotherapy, and radiotherapy, as well as responses across histological subtypes. Drawing from ongoing early-phase trials and innovative approaches like CRISPR editing and dual-targeting, we highlight the progress and challenges in developing CAR-based therapies, underscoring their potential while emphasizing the need for further research to establish clinical efficacy in OC.
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