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:Glioblastoma IDH-wildtype: An integrative review of pathophysiological mechanisms, diagnostic innovations, and emerging therapeutic modalities.
成人中最危险和致命的原发性脑肿瘤是胶质母细胞瘤/IDH野生型胶质母细胞瘤(GBM),其具有进展性、弥漫性,并且对常规治疗无反应。
成人中最危险且致命的原发性脑肿瘤是胶质母细胞瘤/IDH野生型胶质母细胞瘤(GBM),其具有进展性、弥漫性,且对常规治疗无反应。了解GBM的病理生理学、基因突变、分子信号传导路径以及肿瘤-微环境相互作用对于改善临床结局至关重要。正确的诊断基于最先进的神经影像学方法和组织病理学检查,这使得能够准确地对肿瘤进行分级并制定治疗方案。现有的常规治疗包括最大范围切除,随后进行放疗和化疗;然而,相当比例的患者最终会出现复发。最新进展致力于免疫治疗选项,包括免疫检查点抑制剂、CAR-T细胞和树突状细胞疫苗,以增强抗肿瘤免疫。为了提高治疗药物和化疗药物跨越BBB的生物利用度和靶向给药,利用纳米颗粒的药物递送系统引起了关注。含有神经保护和抗增殖作用的草药和植物化学化合物也正在作为辅助治疗进行研究,以调节肿瘤生长并减少副作用。本文对GBM进行了批判性总结,涵盖病理生理学、诊断方式、传统治疗干预和先进治疗选项。通过强调免疫治疗、纳米医学和草药干预领域的最新进展,本文突出了利用多模式治疗改善患者结局的可能性,并为GBM管理的未来转化研究提供了基础。
The most dangerous and fatal primary brain tumor in adults is glioblastoma multiforme/IDH wild-type glioblastoma (GBM), which is progressive, diffuse, and unresponsive to conventional treatment. Knowledge of the pathophysiology of GBM, genetic mutations, molecular signal transport paths, and tumor-microenvironment interactions is essential in improving clinical outcomes. Proper diagnosis is based on the most sophisticated neuroimaging methods and histopathologic examination, which makes it possible to grade the tumor accurately and establish treatment. Existing conventional therapy involves maximum resection followed by radiotherapy and chemotherapy; however, a considerable percentage of patients will eventually experience recurrence. The latest developments have been dedicated to those immunotherapy options, including immune checkpoint inhibitors, CAR-T cells, and dendritic cell vaccines, to augment anti-tumor immunity. To improve the bioavailability and targeted administration of therapeutic and chemotherapeutic drugs across the BBB, drug delivery systems utilizing nanoparticles have gained interest. Herbal and phytochemical compounds containing neuroprotective and anti-proliferative effects are also under investigation as adjunct therapy to regulate tumor growth and decrease side effects. The paper presents a critical summary of GBM, which incorporates pathophysiology, diagnostic modalities, traditional treatment interventions, and advanced treatment options. Through the emphasis on recent advances in the fields of immunotherapy, nanomedicine, and herbal interventions, this article highlights the possibility of using multimodality in achieving improved patient outcomes and provides the basis of future translational studies in the management of GBM.
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