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:Targeting T-Cells for Cancer Treatment: Current Clinical Strategies and Challenges.
Targeting T-Cells for Cancer Treatment: Current Clinical Strategies and Challenges.
对靶向肿瘤细胞的免疫应答进行调节已被证明是一种成功的癌症治疗策略。
调节针对靶肿瘤细胞的免疫反应已被证明是一种成功的癌症治疗策略。在过去几年中,免疫治疗已融入癌症治疗,PD-1 阻断剂已成为多种癌症类型治疗方案的骨干。在过去十年中,美国 FDA 批准了多类免疫疗法,如免疫检查点阻断剂、双特异性抗体、嵌合抗原受体(CAR)T 细胞和TIL(肿瘤浸润淋巴细胞),还有更多疗法正在临床试验中。重定向效应 T 细胞以治疗癌症的研究旨在解决实体瘤中有限的应答、耐药性的出现、限制治疗的不良事件以及后勤方面的挑战。双特异性免疫检查点阻断剂旨在简化联合治疗;双特异性 T 细胞衔接器旨在将效应 T 细胞与肿瘤细胞连接起来;以及旨在提高实体瘤疗效的下一代 CAR T 细胞和下一代 TIL 疗法,目前均处于临床评估中。本叙述性综述旨在总结 T 细胞导向免疫治疗的现状,描述其发展简史、临床成功、挑战以及正在临床评估中的最新进展。本综述讨论了从单克隆抗体到双特异性抗体和双特异性T细胞衔接器的演变、过继性细胞疗法的最新进展,包括针对实体瘤的CAR T细胞优化、异体通用型CAR T细胞和体内CAR T细胞疗法,以及这些疗法面临的关键挑战,如原发性和获得性耐药、在实体瘤中疗效有限、生产和物流方面的挑战,以及治疗相关毒性。
Modulation of immune response to target tumor cells has been shown to be a successful strategy for cancer treatment. Over the past years immunotherapy has been integrated into cancer treatment and PD-1 blockers have become the backbone of treatment regimens for multiple cancer types. Several classes of immunotherapies, such as immune checkpoint blockers, bispecific antibodies, chimeric antigen receptor (CAR) T-cells, and tumor-infiltrating lymphocytes (TILs), were approved by the US FDA in the last decade and many more are in clinical trials. Research on redirecting effector T-cells to treat cancer has been aimed at addressing the limited responses in solid tumors, emergence of resistance, treatment-limiting adverse events and logistical challenges. Bispecific immune checkpoint blockers, developed to simplify the combination therapies; bispecific T-cell engagers, developed to connect the effector T-cells with tumor cells; and the next generation of CAR T-cells and the next generation of TIL therapies, developed to improve efficacy in solid tumors, are currently under clinical evaluation. This narrative review aims to summarize the current status of T-cell-directed immunotherapy, describing the brief history of development, clinical success, challenges and latest advancements that are under clinical evaluation. Evolution of monoclonal antibodies to bispecific antibodies and bispecific T-cell engagers, the latest advances in adoptive cell therapies, including the optimization of CAR T-cells for solid tumors, allogenic, universal CAR T-cells and in vivo CAR T-cell therapies are discussed in the review along with the key challenges of the therapies, such as primary and acquired resistance, limited efficacy in solid tumors, manufacturing and logistical challenges, and treatment-related toxicities.
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