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:Next-generation immune cell therapies for lung cancer: advances in CAR-T, NK, and TIL strategies.
这些下一代免疫细胞疗法代表了一种快速发展和具有转化相关性的方法,可能扩大治疗选择、改善生存,并在已耗尽常规疗法的肺癌患者中提供持久的抗肿瘤反应。
肺癌仍是全球癌症相关死亡的主要原因,当前疗法对晚期疾病患者的生存获益有限。尽管免疫检查点抑制剂和靶向治疗改善了一些人群的结局,但大多数患者要么无应答,要么产生获得性耐药,凸显了对更有效、更持久免疫治疗策略的需求。下一代免疫细胞疗法,包括CAR-T 细胞(CAR T)、嵌合抗原受体NK 细胞(CAR NK)和TIL(肿瘤浸润淋巴细胞),为常规治疗难治的肺癌提供了一种有前景的方法。这些疗法利用患者自身的免疫系统或工程化免疫细胞直接识别并清除恶性细胞,同时可能克服免疫抑制性肿瘤微环境。本综述全面综合了 CAR T、CAR NK 和 TIL 疗法在非小细胞肺癌和小细胞肺癌中设计、工程化和临床开发的最新进展。我们讨论了证明可行性、安全性和作用机制的临床前和早期临床研究,包括抗原靶向、免疫细胞持久性、迁移和瘤内活性。关键挑战,如肿瘤抗原异质性、免疫抑制、持久性有限和脱靶毒性,被批判性评估。我们还探讨了增强疗效的新兴策略,包括多抗原靶向、装甲化和逻辑门控构建体、区域递送、与检查点抑制或其他调节剂联合,以及可扩展的现货型制造平台。总体而言,这些下一代免疫细胞疗法代表了一种快速发展和具有转化相关性的方法,可能扩大治疗选择、改善生存,并在已耗尽常规疗法的肺癌患者中提供持久的抗肿瘤反应。
Lung cancer remains the leading cause of cancer-related mortality worldwide, and current therapies offer limited survival benefit for patients with advanced disease. While immune checkpoint inhibitors and targeted therapies have improved outcomes in some populations, most patients either fail to respond or develop acquired resistance, highlighting the need for more potent and durable immunotherapeutic strategies. Next-generation immune cell therapies, including chimeric antigen receptor T cells (CAR T), chimeric antigen receptor natural killer cells (CAR NK), and tumor-infiltrating lymphocytes (TIL), provide a promising approach for lung cancers that are refractory to conventional treatment. These therapies leverage the patient's own immune system or engineered immune cells to directly recognize and eliminate malignant cells, while potentially overcoming immunosuppressive tumor microenvironments. This review provides a comprehensive synthesis of recent advances in the design, engineering, and clinical development of CAR T, CAR NK, and TIL therapies in both non-small cell and small cell lung cancer. We discuss preclinical and early clinical studies demonstrating feasibility, safety, and mechanisms of action, including antigen targeting, immune cell persistence, trafficking, and intratumoral activity. Key challenges, such as tumor antigen heterogeneity, immune suppression, limited durability, and off-tumor toxicity, are critically evaluated. We also examine emerging strategies to enhance efficacy, including multi-antigen targeting, armored and logic-gated constructs, regional delivery, combination with checkpoint inhibition or other modulators, and scalable off-the-shelf manufacturing platforms. Collectively, these next-generation immune cell therapies represent a rapidly evolving and translationally relevant approach that may expand therapeutic options, improve survival, and provide durable antitumor responses in patients with lung cancer who have exhausted conventional therapies.
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