CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:The broad spectrum of cancer and immunotherapy: achievements and limitations.
The broad spectrum of cancer and immunotherapy: achievements and limitations.
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癌症免疫治疗在过去几十年中革新了癌症治疗,为既往无法治疗的恶性肿瘤患者带来新的希望。该治疗方式主要分为三类:免疫检查点阻断、过继细胞疗法和癌症疫苗。免疫检查点抑制剂通过阻断癌细胞用来逃避免疫监视的免疫抑制信号,尤其是对细胞毒性T淋巴细胞的抑制,成功增强抗肿瘤免疫应答。过继细胞疗法,尤其是嵌合抗原受体(CAR)T细胞疗法,通过输注经基因改造的细胞毒性T细胞特异靶向肿瘤细胞,在血液系统恶性肿瘤中表现出突出疗效。癌症疫苗也成为一种有前景的策略,可利用患者自身免疫系统诱发抗肿瘤应答。尽管取得这些进展,仍存在若干挑战,尤其是实体瘤治疗,包括肿瘤耐药、导致不良反应的脱靶效应、制备复杂以及患者临床结局差异。克服这些局限需要进一步研究和创新,以优化免疫治疗临床转化并扩大其在更个体化医疗中的应用。本综述重点介绍上述癌症免疫治疗策略的进展和关键挑战,特别关注增强针对肿瘤细胞的适应性免疫系统。
此外,文章还总结了一些通过调节先天免疫系统发挥作用的替代方法。
Cancer immunotherapy has revolutionized cancer treatment over the past decades, offering renewed hope to patients with previously untreatable malignancies. This therapeutic approach could be categorized into three primary strategies: immune checkpoint blockade, adoptive cell therapy, and cancer vaccines. Immune checkpoint inhibitors have been highly successful in boosting anti-tumour immune responses by blocking the immunosuppressive signals that cancer cells exploit to evade immune surveillance, mainly that exerted by cytotoxic T lymphocytes. Adoptive cell therapy, particularly chimeric antigen receptor (CAR)-T cell therapy, involves the infusion of genetically modified cytotoxic T cells to specifically target tumour cells, showing particular efficacy in hematological malignancies.
Cancer vaccines have also emerged as a promising strategy, eliciting anti-tumour responses via the patient's own immune system. Despite these advancements, several challenges persist, particularly in the treatment of solid tumours. These include the development of tumour resistance, off-target effects that lead to adverse side effects, manufacturing complications, and variability in patient clinical outcomes.
Overcoming these limitations will require further research and innovation to optimize the clinical translation of immunotherapy and broaden its application toward more personalized medicine. This review highlights the advancements and key challenges in the mentioned cancer immunotherapy strategies, with a special emphasis on the reinforcement of adaptive immune system against tumour cells.
Additionally, some alternative approaches relying on the modulation of innate immune system are also summarized.
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