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CAR-T 治疗的疗效、安全性和成本效果

英文原题:Efficacy, safety and cost-effectiveness of CAR-T therapy.

PubMed 2026/02/18(内容时间) Br J Clin Pharmacol Q2 · IF 3(JCR 2025)

研究概要

嵌合抗原受体(CAR)T 细胞疗法是免疫治疗领域的一项突破性发现,主要因其在治疗血液系统恶性肿瘤方面的卓越疗效而闻名。

中文摘要

嵌合抗原受体(CAR)T细胞疗法是免疫治疗领域的一项突破性发现,尤其以其治疗血液系统恶性肿瘤的卓越疗效而闻名。最新研究显示,CAR-T细胞疗法的潜力远不止于当前应用范围,还可能成为治疗多种癌症的新方法。本综述总结CAR-T细胞疗法用于癌症治疗的最新创新,包括多发性骨髓瘤、骨肉瘤、胶质母细胞瘤、黑色素瘤及多种儿童恶性肿瘤。然而,抗原逃逸、“靶向肿瘤外组织”毒性、肿瘤实体组织浸润困难以及成本效益等问题,限制了CAR-T疗法的成功。要改进现有癌症免疫疗法,需提高CAR-T细胞治疗难治性肿瘤和实体瘤的能力。可通过靶向不同抗原、增强局部递送和肿瘤浸润能力,以及联合免疫检查点阻断等免疫疗法(如PD-1阻断与CD19 CAR-T联合治疗)实现。尽管CAR-T治疗前景广阔,仍须考虑其成本,尤其是在资金有限的卫生系统中。更重要的是,卫生技术评估(HTA)框架必须纳入伦理、社会学和心理学因素。降低CAR-T细胞毒性也至关重要,因为毒性仍是其在临床广泛应用的最大障碍之一。因此,未来研究应着重加深对CAR-T细胞疗法的认识,并拓展免疫疗法在治疗中的应用。

展开英文摘要原文

Chimeric Antigen Receptors (CAR) T-cell therapy is a ground-breaking discovery in immunotherapy, mainly known for its exceptional results in treating haematological malignancies. The latest research has revealed that the potential of CAR T-cell therapy extends far beyond its current capabilities and could represent a novel therapeutic approach for treating various cancers. This review aims to summarize the latest innovations in CAR T-cell therapy applied in cancer treatment, including multiple myeloma, osteosarcoma, glioblastoma, melanoma and various childhood malignancies. However, several challenges limit success of CAR T-cell therapy, including the antigen escape phenomenon, 'on-target off-tumour' toxicity, penetration into solid tumour tissue, alongside the cost-effectiveness concerns. The improvement of cancer immunotherapies currently available requires an increase in the effectiveness of CAR T-cells in managing refractory and solid cancers. This could be achieved by using CAR T-cells to target various antigens, enhancing their local delivery and tumour infiltration capabilities and utilizing CAR T-cells in combination with checkpoint blockade and immunotherapy, such as PD-1 blockade and CD19 CAR T-cell combined therapy. Although CAR T-cell treatment offers a lot of promise, its cost needs to be taken into account, especially in healthcare systems with limited funding. More importantly, frameworks for Health Technology Assessment (HTA) must adapt to incorporate ethical, sociological and psychological aspects. Reducing CAR T-cell toxicity is also essential, as it remains among biggest obstacles to their widespread application in clinical practice. Future research should therefore focus on enhancing our understanding of CAR T-cell therapy and expanding the application of immunotherapy in treatment.

论文信息

作者
Sher EK、Džidić-Krivić A、Pinjic E、Selak N、Omerbasic K、Chupin A、Belancic A、Fajkic A
第一作者单位
International Society of Engineering Science and Technology, Nottingham, UK.United Kingdom
通讯作者单位
Department of Pathophysiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
文献类型
综述
期刊
British journal of clinical pharmacology2026 Feb 18
原文标识
PubMed 41709681 · DOI 10.1002/bcp.70478