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肝细胞癌的下一代治疗:CAR-T 细胞与抗癌肽的协同作用

英文原题:Next-generation therapies for hepatocellular carcinoma: CAR-T cell and anticancer peptide synergy.

PubMed 2026/01/24(内容时间) Int J Biol Macromol Q1 · IF 8.7(JCR 2025)

研究概要

肝细胞癌(HCC)是最常见的原发性肝癌,其特征为诊断偏晚、治疗效果有限以及高度免疫抑制的肿瘤微环境。

中文摘要

肝细胞癌(HCC)是最常见的原发性肝癌,其特征包括诊断较晚、治疗效果有限及高度免疫抑制性肿瘤微环境。慢性肝损伤、纤维化和炎症是HCC发病机制的核心,尤其在活性氧(ROS)导致的氧化应激下,会引起遗传和表观遗传改变。Wnt/β-catenin等通路异常激活可导致不受控制的增殖、凋亡耐受和转移。本综述强调免疫治疗,尤其是免疫检查点抑制剂和CAR-T(CAR-T)细胞疗法,如何改变HCC治疗方法。针对GPC3、AFP和PD-L1等抗原的新型CAR-T设计已开发,以应对抗原异质性、T细胞耗竭和肿瘤浸润不足。肿瘤微环境中的突变型p53和PD-L1会抑制T细胞活性,构成治疗挑战。此外,Tv1、SHLP6、R-Tf-D-LP4和MOTS-c等抗癌肽(ACP)具有选择性细胞毒性、线粒体靶向能力,并可破坏促肿瘤通路。PIR NPs、ThermoDox和脂质体药物制剂等纳米疗法可提高药物稳定性、递送效率和特异性,实现控释并减少毒性。CAR-T疗法与ACP、纳米医学及双重检查点阻断(如tremelimumab联合durvalumab、nivolumab联合ipilimumab)整合后,显示肿瘤退缩和生存改善。调节ROS水平、抑制血管生成及采用肽—药物偶联物的联合策略,在临床前和早期临床研究中显示前景。本综述强调新一代肽类、细胞和纳米平台治疗之间的协同潜力,有望改善晚期HCC治疗结局。

展开英文摘要原文

Hepatocellular carcinoma (HCC), the most common primary liver cancer, is characterized by late diagnosis, limited treatment efficacy, and a highly immunosuppressive tumour microenvironment. Chronic liver injury, fibrosis, and inflammation are central to HCC pathogenesis, leading to genetic and epigenetic changes, particularly under oxidative stress from reactive oxygen species (ROS). Aberrant activation of pathways such as Wnt/ -catenin, contributes to uncontrolled proliferation, resistance to apoptosis, and metastasis. This review emphasizes how immunotherapy particularly immune checkpoint inhibitors and chimeric antigen receptor T (CAR-T) cell therapy, has reshaped HCC treatment approaches. Advances in CAR-T designs targeting antigens like GPC3, AFP, and PD-L1, have been engineered to address antigen heterogeneity, T-cell exhaustion, and poor tumour infiltration. Mutant p53 and PD-L1 in the tumour microenvironment pose challenges to therapy by suppressing T-cell activity. Furthermore, anticancer peptides (ACPs), such as Tv1, SHLP6, R-Tf-D-LP4, and MOTS-c, exhibit selective cytotoxicity, mitochondrial targeting, and disruption of tumour-promoting pathways. Nanotherapeutics like PIR NPs, ThermoDox, and liposomal drug formulations improve drug stability, delivery, and specificity, providing controlled release and reduced toxicity. The integration of CAR-T therapy with ACPs, nanomedicine, and dual-checkpoint blockade such as tremelimumab-durvalumab, and nivolumab-ipilimumab demonstrate improved tumour regression and survival outcomes. Combination strategies that modulate ROS levels, inhibit angiogenesis, and utilize peptide-drug conjugates show promise in preclinical and early clinical studies. This review highlights the therapeutic synergy of next-generation peptide, cellular, and nanoplatform-based therapies in enhancing outcomes for advanced HCC.

论文信息

作者
Kannan HT、Pan I
第一作者单位
Institute of Biotechnology, Department of Medical Biotechnology, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 602105, Tamil Nadu, India.India
通讯作者单位
Institute of Biotechnology, Department of Medical Biotechnology, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 602105, Tamil Nadu, India. Electronic address: ieshitapan.sse@saveetha.com.India
文献类型
综述
期刊
International journal of biological macromolecules2026 Feb
原文标识
PubMed 41587709 · DOI 10.1016/j.ijbiomac.2026.150512