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探索罕见肿瘤的个体化用药机会与优化 TIL(肿瘤浸润淋巴细胞)治疗:一项基于类器官的神经内分泌肿瘤患者全流程临床映射研究

英文原题:Discover personalized drug opportunity and optimized tumor-infiltrating lymphocyte therapy for rare cancer: an organoid-based whole-journey clinical mapping study in a neuroendocrine cancer patient.

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Discover personalized drug opportunity and optimized tumor-infiltrating lymphocyte therapy for rare cancer: an organoid-based whole-journey clinical mapping study in a neuroendocrine cancer patient.

PubMed 2026/02/24(内容时间) Cell Oncol (Dordr) Q1 · IF 5.6(JCR 2025)

研究概要

本研究证实,罕见癌症患者的生存取决于整合的、个体化的伴随诊断与治疗优化。

中文摘要

目的:罕见癌症患者因肿瘤恶性程度高且治疗选择有限,预后严峻,亟需个体化策略。本研究旨在利用个体化肿瘤类器官(PTO)作为发现平台,全面探索并提出新的治疗机会,评估精准医学延长罕见癌症患者生存期的潜力。 方法:我们对一例化疗耐药、发生转移的神经内分泌宫颈癌(NECC)患者进行了全程临床映射。建立来自三处复发病灶的纵向PTO及自体TIL(肿瘤浸润淋巴细胞),以关联临床应答并发现新疗法。研究构建了PTO与自体TIL共培养系统,以模拟临床应答,并通过重建肿瘤抗原微环境优化TIL疗法。 结果:PTO重现了肿瘤演化及耐药特征,使研究者得以在化疗失败后发现一种高效候选靶向疗法。共培养系统忠实模拟了临床免疫治疗应答,验证了其作为伴随诊断的潜力。利用PTO在TIL生产过程中重建自体肿瘤抗原微环境,获得了个体化优化的TIL群体。这些优化TIL的抗肿瘤能力增强,其给药与患者临床肿瘤消退相关。该PTO优化策略的普适性还在不同患者和癌种中得到验证。 结论:本研究表明,罕见癌症患者的生存获益取决于整合式个体化伴随诊断和治疗优化。通过将迭代肿瘤模型与临床干预相结合,我们提出了可扩展的概念框架,以克服治疗虚无主义并释放精准治疗带来的生存获益。

展开英文摘要原文

PURPOSE: Rare cancer patients face dire prognoses due to high malignancy and scarce treatment options, underscoring an imperative for personalized strategies. This study aims to evaluate the potential of precision medicine to extend survival in rare cancer patients by leveraging personalized tumor organoids (PTOs) as a discovery platform to comprehensively explore and generate new treatment opportunities. METHODS: We performed whole-journey clinical mapping in a neuroendocrine cervical cancer (NECC) patient with chemo-resistant metastases. Longitudinal PTOs from three recurrent lesions and autologous tumor-infiltrating lymphocytes (TILs) were established to correlate clinical responses and discover new therapies. A co-culture system integrating PTOs and autologous TILs was developed to replicate clinical responses and optimize TIL therapy through rebuilding tumor antigen microenvironment. RESULTS: PTOs recapitulated tumor evolution and resistance imprints, enabling identification of a highly effective targeted therapy candidate post-chemotherapy failure. The co-culture system faithfully mirrored clinical immunotherapy responses, validating its potential as a companion diagnostic. Utilizing PTOs to rebuild the autologous tumor antigen microenvironment during TIL production generated a personalized, optimized TIL population. These optimized TILs exhibited enhanced anti-tumor ability and their administration correlated with clinical tumor regression in the patient. Generalizability of this PTO-based optimization strategy was validated across both patients and cancer types. CONCLUSION: This study establishes that survival for rare cancer patients hinges on integrated, personalized companion diagnostics and therapy optimization. By bridging iterative tumor models with clinical interventions, we provide a scalable conceptual framework to overcome therapeutic nihilism and unlock precision-driven survival benefits.

论文信息

作者
Gao X、Liu Z、Xu Z、Liu K、Zhang Y、Yu J、Wang X、Cheng X
第一作者单位
State Key Laboratory of Genetic Engineering, Human Phenome Institute, Fudan University, Shanghai, 200438, China.China
通讯作者单位
The MOE Basic Research and Innovation Center for the Targeted Therapeutics of Solid Tumors, School of Basic Medical Sciences, Institute of Organoid Research, The First Affiliated Hospital, Nanchang University, Nanchang, 330031, China. bingzhao@ncu.edu.cn.China
文献类型
病例报告
期刊
Cellular oncology (Dordrecht, Netherlands)2026 Feb 24
原文标识
PubMed 41733805 · DOI 10.1007/s13402-026-01172-y