CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Imaging Immunotherapy.
Imaging Immunotherapy.
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癌症免疫治疗旨在通过利用适应性和先天免疫机制,增强或重新激活免疫系统功能。刺激肿瘤特异性免疫应答的主要方法包括细胞因子疗法、癌症疫苗和免疫检查点阻断。2011 年靶向 CTLA-4 的 ipilimumab 获批后,该领域经历了变革性发展,为后续 PD-1 和 PD-L1 通路抑制剂铺平道路;这些药物在多种恶性肿瘤中带来前所未有的生存获益。这些突破推动过继性 T 细胞疗法进步,尤其是通过输注基因改造 CAR-T 细胞显示出良好临床疗效,标志肿瘤治疗模式转变。与此同时,疗效评估面临新挑战。免疫治疗的应答模式常与传统化疗不同,尤其体现在假性进展、临床效应延迟和疾病稳定时间延长等现象。为应对这些独特动态,研究者修订了疗效评估指南,以改进治疗开发和临床决策。本章考察免疫治疗特异性评估标准的发展及其在临床试验中的应用和实践影响,并以对未来疗效分类系统进展的展望作结。
Cancer immunotherapy aims to enhance or reactivate immune system function by leveraging both adaptive and innate immunity mechanisms. Key approaches to stimulate tumor-specific immune responses include cytokine therapies, cancer vaccines, and immune checkpoint blockade. The field experienced transformative growth after the 2011 approval of ipilimumab (targeting CTLA-4), paving the way for subsequent inhibitors of PD-1 and PD-L1 pathways that demonstrated unprecedented survival benefits across multiple malignancies. These breakthroughs have catalyzed advancements in adoptive T cell therapies, particularly genetically modified CAR T cell infusions showing promising clinical efficacy, signaling a paradigm shift in oncology treatment approaches.
Meanwhile, response assessment has faced new challenges. In fact, immunotherapy response patterns often contrast with conventional chemotherapy, particularly regarding phenomena like pseudoprogression, delayed clinical effects, and extended disease stabilization.
To address these unique dynamics, revised response assessment guidelines have been established to enhance therapeutic development and clinical decision-making. This chapter examines the progression of immune-specific evaluation standards, their application in clinical trials, and their practical consequences, concluding with insights into future advancements in response classification systems.
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