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:The safety and efficacy of bispecific T-cell engagers (TCEs) in patients with glioma.
The safety and efficacy of bispecific T-cell engagers (TCEs) in patients with glioma.
作为中枢神经系统最具侵袭性和耐药性的肿瘤之一,胶质母细胞瘤(GBM)预后差且可用治疗手段很少。
胶质母细胞瘤(GBM)是中枢神经系统侵袭性最强、耐药性最高的肿瘤之一,预后差且可用治疗有限。由于肿瘤具有浸润性、免疫抑制性环境及耐药机制,放疗、化疗和手术等传统治疗仅带来有限生存获益。双特异性T细胞衔接器(TCE)已显示有希望的临床前及早期临床结果,免疫疗法由此成为可行策略。TCE可将细胞毒性T淋巴细胞(CTL)引导至肿瘤相关抗原(TAA),如EGFRvIII配体、IL-13Rα2、Fn14和NKG2D配体(NKG2DL),从而促进强效肿瘤裂解。尽管AMG 596的I期临床研究显示安全性可接受并初步提示疗效,临床前小鼠研究也观察到生存延长,但仍存在TCE分子半衰期短、T细胞浸润有限、抗原异质性,以及神经毒性或细胞因子释放综合征(CRS)风险等挑战。有前景的进展包括多价靶向、DNA编码或细胞递送TCE,以及与免疫检查点抑制剂(ICI)或CAR-T联合。本综述重点关注将TCE免疫疗法纳入多模式治疗,介绍其安全性、有效性及治疗胶质瘤的潜在用途。
Among the most aggressive and resistant tumors of the central nervous system, glioblastoma (GBM) has a poor prognosis and few available treatments. Because of the tumor's infiltrative nature, immunosuppressive environment, and resistance mechanisms, traditional treatments such as radiotherapy, chemotherapy, and surgery offer only modest survival benefits. Bispecific T-cell engagers (TCEs) have shown promising preclinical and early clinical results, and immunotherapy has become a feasible strategy. TCEs efficiently promote antigen evasion and strong tumor lysis by directing cytotoxic T lymphocytes (CTLs) to tumor-associated antigens (TAA) such as the EGFRvIII ligands IL-13R 2, Fn14, and NKG2D ligands (NKG2DLs). Although phase I clinical studies with AMG 596 have shown acceptable safety profiles and early indications of efficacy, preclinical mice have demonstrated prolonged longevity. However, challenges still exist, including the short half-life of TCEs molecules, limited T-cell infiltration, antigen heterogeneity, and the risk of neurotoxicity or cytokine release syndrome (CRS). Promising developments include novel approaches such as multivalent targeting, DNA-encoded or cell-delivered TCEs, and combinations with immune checkpoint inhibitors (ICIs) or CAR-T cells. With an emphasis on its integration into multimodal treatment approaches, this review highlights the safety, effectiveness, and potential uses of TCEs immunotherapy for gliomas.
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