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胶质母细胞瘤 CAR-T 细胞治疗:克服免疫屏障与推进临床转化

英文原题:CAR-T Cell Therapy in Glioblastoma: Overcoming Immunological Barriers and Advancing Clinical Translation.

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CAR-T Cell Therapy in Glioblastoma: Overcoming Immunological Barriers and Advancing Clinical Translation.

PubMed 2026/02/17(内容时间) Cancer Manag Res Q3 · IF 2.6(JCR 2025)

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中文摘要

嵌合抗原受体(CAR)T细胞疗法在血液系统恶性肿瘤中带来了前所未有的临床获益,但成功转化用于实体瘤仍是尚未解决的重大临床挑战。胶质母细胞瘤(GBM)是侵袭性最强的原发性脑肿瘤之一,集中体现了细胞免疫疗法面临的障碍,包括显著的瘤内异质性、抗原逃逸、高度免疫抑制性肿瘤微环境,以及血脑屏障带来的解剖限制。这些因素共同限制CAR-T 细胞在中枢神经系统中的迁移、持久存在和持续抗肿瘤活性。本综述考察了旨在克服GBM上述障碍的新一代CAR-T 工程策略的最新进展。主要进展包括:用于减轻肿瘤免疫逃逸的多抗原及逻辑门控CAR设计;能够递送细胞因子或抵抗TGF-β等抑制性介质的装甲型CAR-T 细胞;以及用于对抗功能耗竭的免疫检查点耐受型构建体。

我们还介绍了新兴递送模式,包括局部区域给药、病毒载体和纳米技术平台,旨在增强穿越血脑屏障的能力并提高瘤内滞留。此外,我们讨论了CAR-T 疗法与免疫检查点阻断、溶瘤病毒疗法及其他免疫调节干预相结合的策略,以重塑GBM恶劣的微环境并增强疗效。

最后,我们探讨了更广泛临床应用前必须解决的主要转化挑战,包括神经毒性、规模化生产及预测性临床前模型的开发。总体而言,这些多学科进展为优化GBM CAR-T 细胞疗法并加速其转化、实现持久临床获益提供了路线图。

展开英文摘要原文

Chimeric antigen receptor (CAR) T-cell therapy has delivered unprecedented clinical benefit in hematological malignancies, yet its successful translation to solid tumors remains a major unmet clinical challenge. Glioblastoma (GBM), the most aggressive primary brain tumor, exemplifies the barriers confronting cellular immunotherapy, including profound intratumoral heterogeneity, antigenic escape, a highly immunosuppressive tumor microenvironment, and anatomical constraints imposed by the blood-brain barrier.

Together, these features limit CAR-T cell trafficking, persistence and sustained antitumor activity in the central nervous system. In this Review, we examine recent advances in next-generation CAR-T engineering strategies aimed at overcoming these obstacles in GBM. Key developments include multi-antigen and logic-gated CAR designs to mitigate tumor immune evasion, armored CAR-T cells capable of cytokine delivery or resistance to suppressive mediators such as TGF- , and checkpoint-resistant constructs to counteract functional exhaustion.

We also highlight emerging delivery paradigms - including locoregional administration, viral vectors and nanotechnology-enabled platforms - designed to enhance blood-brain barrier penetration and intratumoral retention.

Furthermore, we discuss combinatorial strategies integrating CAR-T therapy with immune checkpoint blockade, oncolytic virotherapy and other immunomodulatory interventions to remodel the hostile glioblastoma microenvironment and amplify therapeutic efficacy.

Finally, we address the principal translational challenges that must be resolved for broader clinical implementation, including neurotoxicity, manufacturing scalability and the development of predictive preclinical models. Collectively, these multidisciplinary advances provide a roadmap for optimizing CAR-T cell therapy in glioblastoma and accelerating its translation toward durable clinical benefit.

论文信息

作者
Pourmasoumi P、Pourmasoumi A、Zamani F、Amini A、Shokri S
第一作者单位
Department of Biomedical Engineering, Central Tehran Branch, Islamic Azad University, Tehran, Iran.Iran
通讯作者单位
School of Medicine, Iran University of Medical Sciences, Tehran, Iran.Iran
文献类型
综述
期刊
Cancer management and research2026
原文标识
PubMed 41737136 · DOI 10.2147/CMAR.S580320