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减少 CAR-T 细胞治疗副作用的新兴策略:聚焦基因编辑与纳米技术

英文原题:Emerging strategies to reduce the side effects of CAR-T cell therapy: focusing on gene editing and nanotechnology.

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Emerging strategies to reduce the side effects of CAR-T cell therapy: focusing on gene editing and nanotechnology.

PubMed 2026/01/04(内容时间) Clin Transl Oncol Q3 · IF 2.7(JCR 2025)

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中文摘要

CAR-T 细胞疗法已变革部分血液系统恶性肿瘤治疗,并逐渐用于实体瘤等其他恶性肿瘤。尽管疗效显著,CAR-T 治疗常伴随严重且可能危及生命的不良反应和毒性,包括细胞因子释放综合征(CRS)、免疫效应细胞相关神经毒性综合征(ICANS)、异体治疗中的移植物抗宿主病(GvHD)、继发性CAR-T 来源恶性肿瘤,以及长期免疫抑制造成的感染风险。近期将基因编辑技术和纳米医学融入CAR-T 疗法的进展,开辟了提高其安全性并扩大临床应用的新途径。基因编辑工具可靶向调节CAR-T 细胞基因组,从而预防相关副作用、改善安全性;纳米医学则可用于制备及治疗后多个阶段,以预防或管理这些毒性。本综述概述当前临床前和临床研究格局,探讨新兴组合策略,并讨论实现更安全、可控CAR-T 疗法的未来方向。

展开英文摘要原文

CAR-T cell therapy has been transformative in treating certain blood malignancies and is also being adopted for treating other malignancies, including solid tumors. Despite its undeniable successes, CAR-T cell therapy is frequently associated with severe and potentially life-threatening side effects and toxicities, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity (ICANS), graft-versus-host disease (GvHD) in allogeneic settings, secondary CAR-T-derived malignancies, and long-term immunosuppression-induced risk of infections.

Recent advances in integrating gene-editing technology and nanomedicine into CAR-T cell therapy have opened new avenues to enhance the safety profile of CAR-T cell therapy and broaden its clinical applications. Gene-editing tools enable targeted modulation of the CAR-T cells' genome, thereby improving their safety profile by preventing related side effects.

In parallel, nanomedicine can be used at various stages, including manufacturing and post-treatment, to prevent their occurrence or manage them. This review highlights the current preclinical and clinical landscape, explores the emerging combinatorial strategies, and discusses future directions to achieve a safe and more controllable CAR-T cell therapy.

论文信息

作者
Dong J、Nikolenko DA、Boymuradov S、Garifulina L、Khodabandehloo E
第一作者单位
Department of Hepatobiliary and Pancreatic Surgery, People's Hospital of BANAN District, Chongqing City, China.China
通讯作者单位
Department of Immunology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Elnaz.azimuno@gmail.com.Iran
文献类型
综述
期刊
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026 Jun
原文标识
PubMed 41485186 · DOI 10.1007/s12094-025-04185-5