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:Nanomedicine Meets Immunotherapy: Advancing Adoptive Cell Therapy with Nanoparticles in the Treatment of Cancer with Sustainability Perspectives.
免疫治疗在某些癌症中取得了显著的临床成功,特别是通过过继性细胞疗法(ACT),其中利用嵌合抗原受体(CAR)进行T细胞工程改造,已在血液系统恶性肿瘤的治疗中推动了重大临床突破。
免疫治疗在某些癌症中已取得显著的临床成功,特别是通过过继细胞治疗(ACT),其中利用嵌合抗原受体(CAR)进行T细胞工程改造已在血液系统恶性肿瘤的治疗中推动了重大临床突破。然而,由于多种障碍,包括肿瘤特异性抗原的稀缺、抗原异质性、免疫抑制性肿瘤微环境以及致密细胞外基质对T细胞浸润的物理阻碍,针对实体瘤的疗效仍然有限。基于纳米颗粒(NP)的方法可以克服这些障碍并增强ACT,通过提高肿瘤免疫原性和血管通透性,同时减少对健康组织的脱靶毒性。本综述讨论了利用NP增强ACT的不同策略,包括递送免疫调节剂和化疗药物、NP介导的热疗、磁引导以改善T细胞在肿瘤中的积聚,以及体内NP介导的CAR T细胞生成和激活。虽然优先考虑患者安全至关重要,但这并不能完全反映新型纳米药物相关的风险与挑战范围。在这方面,我们讨论了在开发过程早期整合环境影响评估对于识别关注的关键影响领域并引导创新走向更可持续和负责任的设计至关重要。最后,我们还指出了当前面临的挑战,并讨论了潜在的解决方案和未来研究方向,包括安全性和可持续性。
Immunotherapy has achieved remarkable clinical success in certain cancers, particularly through adoptive cell therapy (ACT), where T cell engineering with chimeric antigen receptor (CAR) has driven major clinical breakthroughs in the treatment of hematologic malignancies. However, efficacy against solid tumors remains limited due to multiple barriers, including the scarcity of tumor-specific antigens, antigen heterogeneity, immunosuppressive tumor microenvironment, and physical obstruction of T cell infiltration by dense extracellular matrix. Nanoparticle (NP)-based approaches can overcome these obstacles and enhance ACT by improving tumor immunogenicity and vascular permeability, while reducing off-target toxicity to healthy tissues. This review discusses different strategies leveraging NPs to enhance ACT, including the delivery of immunomodulators and chemotherapeutics, NP-mediated hyperthermia, magnetic guidance to improve T cell accumulation in tumors, and in vivo NP-mediated generation and activation of CAR T cells. While prioritizing patient safety is essential, it does not fully reflect the range of risks and challenges associated with novel nanomedicines. In this regard, we discuss how integrating environmental impact assessments early in the development process is crucial for identifying key impact areas of concern and steering innovation towards more sustainable and responsible designs. Finally, we also identify current challenges, and discuss potential solutions and future research directions, including safety and sustainability.
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