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:T cell immunotherapy for solid tumors: limitations, progress, and future prospects.
T cell immunotherapy for solid tumors: limitations, progress, and future prospects.
基于 T 细胞的免疫疗法在血液系统恶性肿瘤的治疗中已取得显著成功,尤其是通过嵌合抗原受体(CAR)T 细胞的应用。
T细胞免疫疗法,尤其是嵌合抗原受体(CAR)T细胞,已成功用于血液系统恶性肿瘤。然而,由于肿瘤抗原异质性、免疫抑制性肿瘤微环境(TME)、T细胞浸润和持续性不足等内在及外在障碍,此类方法在实体瘤中的临床疗效仍有限。尽管存在这些挑战,CAR-T、T细胞受体工程化T细胞(TCR-T)及TIL(肿瘤浸润淋巴细胞)治疗实体瘤的开发近年来取得显著进展。本综述全面概述靶向实体瘤的T细胞免疫疗法现状,考察各治疗形式的作用机制和设计原则,并按肿瘤类型总结临床进展。文章特别关注阻碍疗效的生物学和技术挑战,包括抗原逃逸、靶向肿瘤外组织毒性及TME的免疫抑制特征;进一步讨论克服这些障碍的新兴策略,如联合靶向多种抗原、免疫检查点阻断、合成生物学工具及基因编辑技术。最后展望领域未来方向,强调精准免疫治疗及整合多组学数据对增强T细胞功能和特异性的重要性。本文旨在为持续研究提供参考,并指导T细胞疗法向实体瘤临床转化。
T cell-based immunotherapies have achieved notable success in the treatment of hematological malignancies, particularly through the application of chimeric antigen receptor (CAR) T cells. However, the clinical efficacy of such approaches in solid tumors remains limited due to a range of intrinsic and extrinsic barriers, including tumor antigen heterogeneity, the immunosuppressive tumor microenvironment (TME), and insufficient T cell infiltration and persistence. Despite these challenges, significant advances have been made in recent years in the development of CAR-T cells, T cell receptor-engineered T cells (TCR-T), and tumor-infiltrating lymphocytes (TILs) for solid tumors. This review provides a comprehensive overview of the current landscape of T cell immunotherapies targeting solid tumors. We examine the underlying mechanisms and design principles of each therapeutic modality and summarize the clinical progress in a tumor-specific context. Particular attention is given to the biological and technical challenges that impede treatment efficacy, including antigen escape, on-target off-tumor toxicity, and the suppressive features of the TME. Furthermore, we discuss emerging strategies aimed at overcoming these obstacles, such as combinatorial antigen targeting, immune checkpoint blockade, synthetic biology tools, and gene editing technologies. Finally, we outline future perspectives in the field, emphasizing the importance of precision immunotherapy and the integration of multi-omics data to enhance T cell functionality and specificity. This review aims to inform ongoing research and guide the clinical translation of T cell-based therapies for solid tumors.
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