肿瘤细胞治疗研究
英文原题：CAR T-cells in hematologic malignancies: Advances, challenges, and future directions.
嵌合抗原受体（CAR）T细胞疗法已改变血液系统恶性肿瘤的治疗格局，在复发或难治性B细胞急性淋巴细胞白血病、大B细胞淋巴瘤和多发性骨髓瘤中实现了高缓解率。
嵌合抗原受体（CAR）T细胞疗法已彻底改变了血液系统恶性肿瘤的治疗格局，在复发或难治性B细胞急性淋巴细胞白血病、大B细胞淋巴瘤和多发性骨髓瘤中实现了高缓解率。通过将自体或异体T淋巴细胞重定向至CD19和TNFRSF17等肿瘤相关抗原，CAR T细胞克服了传统疗法的耐药性。CAR设计的逐步优化——从早期构建体到装甲型和逻辑门控平台——增强了持久性、特异性和安全性。关键性试验和真实世界证据证实了持久缓解，但挑战依然存在，包括细胞因子释放综合征、神经毒性、生产复杂性、高成本以及全球可及性有限。新兴策略，如多抗原靶向、基因编辑技术和体内CAR递送，旨在提高疗效和可扩展性。人工智能与即时检验生产的整合可能进一步简化生产和患者筛选。持续创新将决定CAR T细胞疗法作为精准血液肿瘤学可扩展支柱的长期影响力。
Chimeric antigen receptor (CAR) T-cell therapy has transformed the management of hematologic malignancies, achieving high remission rates in relapsed or refractory B-cell acute lymphoblastic leukemia, large B-cell lymphoma, and multiple myeloma. By redirecting autologous or allogeneic T lymphocytes against tumor-associated antigens such as CD19 and TNFRSF17 , CAR T-cells overcome resistance to conventional therapies. Progressive optimization of CAR design-from early constructs to armored and logic-gated platforms-has enhanced persistence, specificity, and safety. Pivotal trials and real-world evidence confirm durable responses, although challenges remain, including cytokine release syndrome, neurotoxicity, manufacturing complexity, high cost, and limited global access. Emerging strategies, such as multi-antigen targeting, gene editing technologies, and in vivo CAR delivery, aim to improve efficacy and scalability. Integration of artificial intelligence and point-of-care manufacturing may further streamline production and patient selection. Continued innovation will determine the long-term impact of CAR T-cell therapy as a scalable pillar of precision hematologic oncology.
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