单细胞追踪揭示黑色素瘤 TIL 治疗过程中肿瘤反应性 T 细胞的可塑性
Single-cell tracking reveals tumor-reactive T cell plasticity during melanoma TIL therapy.
TIL(肿瘤浸润淋巴细胞)过继细胞治疗可在转移性黑色素瘤中诱导持久缓解,然而在体外扩增过程中及回输后,调控肿瘤反应性T细胞命运的克隆和转录动态仍知之甚少。
英文原题:Mutant Selective T-Cell Receptor Therapy for Solid Tumors.
Mutant Selective T-Cell Receptor Therapy for Solid Tumors.
晚期实体瘤在很大程度上仍无法治愈,尽管包括免疫检查点阻断在内的现代疗法不断进步,大多数患者最终仍会出现疾病进展。
晚期实体瘤在很大程度上仍无法治愈,尽管包括免疫检查点阻断在内的现代疗法不断进步,大多数患者最终仍会进展。这些方法疗效有限,反映了实体瘤的生物学复杂性,包括瘤内异质性、免疫抑制性微环境以及以“不可成药”致癌驱动因素为主。过继细胞治疗(ACT)通过将肿瘤特异性淋巴细胞直接输注给患者,提供了一种互补策略。在ACT模式中,T细胞受体(TCR)工程化T细胞因其能够识别由MHC分子呈递的细胞内新抗原而尤为突出,从而可覆盖更广泛的抗原谱。早期成功案例,如FDA批准lifileucel和afamitresgene autoleucel,凸显了这些方法的前景,同时概念验证性临床研究证明了个体化新抗原反应性TCR在晚期实体瘤中的活性。重大挑战仍然存在,包括脱靶毒性带来的安全性问题以及HLA杂合性缺失等耐药机制。靶点发现、TCR工程和联合策略方面的持续创新旨在克服这些障碍,并将突变选择性TCR治疗确立为实体瘤治疗中可行的治疗策略。
Advanced solid tumors remain largely incurable, with most patients ultimately progressing despite modern therapies, including immune checkpoint blockade. The limited impact of these approaches reflects the biological complexity of solid tumors, including intratumoral heterogeneity, an immunosuppressive microenvironment, and the predominance of "undruggable" oncogenic drivers. Adoptive cellular therapy (ACT) offers a complementary strategy by delivering tumor-specific lymphocytes directly into patients. Among ACT modalities, T-cell receptor (TCR)-engineered T cells stand out for their ability to recognize intracellular neoantigens presented by MHC molecules, thus accessing a broader antigenic landscape. Early successes, such as the FDA approvals of lifileucel and afamitresgene autoleucel, highlight the promise of these approaches, while proof-of-concept clinical studies demonstrate activity of personalized neoantigen-reactive TCRs in advanced solid tumors. Major challenges remain, including safety concerns from off-tumor toxicities and resistance mechanisms such as HLA loss of heterozygosity. Ongoing innovations in target discovery, TCR engineering, and combination strategies aim to overcome these barriers and establish mutant-selective TCR therapy as a viable therapeutic strategy in the treatment of solid tumors.
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