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乳腺癌管理中的 CAR-T 细胞治疗:拓展视野并克服血液系统肿瘤之外的挑战

英文原题:CAR-T cell therapy in breast cancer management: expanding horizon and overcoming challenges beyond hematologic cancers.

PubMed 2026/04/07(内容时间) Mol Biol Rep Q3 · IF 3.2(JCR 2025)

研究概要

乳腺癌(BC)仍然是发病率最高、治疗最具挑战性的癌症之一,目前的治疗方法往往受到治疗耐药和不良反应的限制。

中文摘要

乳腺癌(BC)仍然是发病率最高、治疗最具挑战性的癌症之一,当前的治疗方法往往受到治疗耐药和不良副作用的限制。CAR-T(CAR-T)细胞疗法是一种通过重新工程化患者T细胞以靶向癌细胞的免疫疗法,已在血液系统恶性肿瘤中显示出显著疗效,目前正在探索其在包括BC在内的实体瘤中的应用。本综述深入概述了CAR-T细胞疗法的机制、设计和开发,重点关注BC实体瘤微环境所带来的独特挑战。具体而言,我们讨论了CAR-T设计的关键组成部分,包括抗原选择(如HER2、MUC1和EGFR)、利用细胞内信号结构域进行的CAR结构优化,以及CRISPR和TALENs等基因工程技术。本综述还讨论了生产制造方面的障碍,如大规模生产和质量控制,并重点介绍了临床前安全性和有效性测试模型。综述回顾了CAR-T疗法在BC中的当前临床数据,包括不同亚型和临床试验的结果,以及新兴的研究性疗法。尽管前景广阔,CAR-T疗法在BC中仍面临重大障碍,如抗原异质性、肿瘤微环境挑战以及细胞因子释放综合征等安全性问题。本文探讨了下一代CAR、联合疗法和肿瘤微环境修饰策略方面的进展,作为应对这些挑战的创新方法。最后,本综述展望了未来方向,包括个性化CAR-T疗法、新靶点发现和生物标志物指导的患者选择,强调CAR-T疗法在重塑乳腺癌治疗方面的潜力。通过全面分析,本文旨在深入探讨CAR-T细胞疗法作为BC管理变革性方法的现状、挑战和未来前景。

展开英文摘要原文

Breast cancer (BC) remains one of the most prevalent and challenging cancers to treat, with current therapeutic approaches often limited by treatment resistance and adverse side effects. Chimeric Antigen Receptor T (CAR-T) cell therapy, a form of immunotherapy that re-engineers patients T-cells to target cancer cells, has shown substantial efficacy in hematologic malignancies and is now being explored for application in solid tumors, including BC. This review provides an in-depth overview of CAR-T cell therapy s mechanism, design, and development, focusing on the unique challenges presented by the solid tumor environment of BC. Specifically, we discuss the critical components of CAR-T design, including antigen selection (e.g., HER2, MUC1, and EGFR), CAR structure optimisation with intracellular signalling domains, and genetic engineering techniques like CRISPR and TALENs. The review also addresses manufacturing hurdles, such as large-scale production and quality control, and highlights preclinical safety and efficacy testing models. Current clinical data on CAR-T therapy in BC, including outcomes from various subtypes and clinical trials, are reviewed, along with emerging investigational therapies. Despite its promise, CAR-T therapy in BC faces significant barriers, such as antigen heterogeneity, tumor microenvironment challenges, and safety concerns like cytokine release syndrome. Advances in next-generation CARs, combination therapies, and tumor microenvironment-modifying strategies are examined as innovative approaches to these challenges. Finally, the review explores future directions, including personalized CAR-T therapy, new target discovery, and biomarker-guided patient selection, emphasizing CAR-T potential of CAR T-therapy in reshaping breast cancer treatment. Through a comprehensive analysis, this article aims to provide insights into the current status, challenges, and future promise of CAR-T cell therapy as a transformative approach to BC management.

论文信息

作者
Parekh KP、Alotaibi FT、Patel DD、Alsaidan OA、Prajapati BG、Alzarea SI、Aljehani AM、Chorawala MR
第一作者单位
Department of Pharmacology and Pharmacy Practice, L. M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India.India
通讯作者单位
Department of Pharmacology and Pharmacy Practice, L. M. College of Pharmacy, Ahmedabad, 380009, Gujarat, India. mchorawalaresearch@gmail.com.India
文献类型
综述
期刊
Molecular biology reports2026 Apr 7
原文标识
PubMed 41944897 · DOI 10.1007/s11033-026-11752-8