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:CAR-T cell immunotherapy in rhabdomyosarcoma.
通过整合这些进展,合理设计的多模式治疗有望克服耐药机制并改善难治性横纹肌肉瘤的结局,为这种历史上难以治愈的恶性肿瘤带来希望。
**背景:**横纹肌肉瘤是最常见的儿童软组织肉瘤,具有侵袭性,高危患者结局较差,仍是治疗难题。本文探讨CAR-T细胞疗法作为横纹肌肉瘤变革性治疗方法的潜力,关注HER2、CD276、FGFR4、PDGFR-β等靶抗原。 **正文:**临床前研究结果令人鼓舞,但迄今临床研究中的抗肿瘤活性有限。临床主要障碍包括抗原异质性、免疫抑制性肿瘤微环境及生产物流问题。本文讨论双靶点CAR、联合免疫检查点阻断及异体平台等创新策略,以应对上述局限。此外,也介绍免疫检查点抑制剂、溶瘤病毒和小分子抑制剂等可能与CAR-T协同的新兴治疗形式。 **结论:**整合这些进展并合理设计多模式治疗,可能克服耐药机制、改善难治性横纹肌肉瘤结局,为这一历来难治的恶性肿瘤带来希望。
BACKGROUND: Rhabdomyosarcoma, the most common pediatric soft tissue sarcoma, remains a therapeutic challenge due to its aggressive nature and poor outcomes in high-risk patients. Herein, we explore the potential of CAR-T cell therapy as a transformative approach for rhabdomyosarcoma, focusing on target antigens such as HER2, CD276, FGFR4, PDGFR- , and others. MAIN BODY: While preclinical studies are promising, antitumor activity in clinical studies to date has been limited. Significant clinical hurdles include antigen heterogeneity, immunosuppressive tumor microenvironments, and logistical barriers in manufacturing. Innovative strategies like dual-targeting CARs, combinatorial checkpoint blockade, and allogeneic platforms are discussed to address these limitations. Additionally, we highlight emerging modalities such as immune checkpoint inhibitors, oncolytic viruses, and small molecule inhibitors that may synergize with CAR-T cell therapy. CONCLUSIONS: By integrating these advances, rationally designed multimodal therapies could overcome resistance mechanisms and improve outcomes for refractory rhabdomyosarcoma, offering hope for a historically incurable malignancy.
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