工程化益生菌用于肿瘤靶向联合化学免疫治疗
Engineered probiotics for tumor-targeted combination chemoimmunotherapy.
肿瘤细胞治疗研究
英文原题:Targeting solid tumors with TCR-T cells: mechanisms, progress, and challenges.
Targeting solid tumors with TCR-T cells: mechanisms, progress, and challenges.
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T细胞受体工程化T细胞(TCR-T)疗法已成为实体瘤治疗的一种有前景策略,因为它能够识别人白细胞抗原(HLA)分子呈递的细胞内抗原,从而将靶向范围扩展至细胞表面蛋白之外。
然而,由于HLA限制、抗原表达异质性、抗原呈递不稳定以及免疫抑制性肿瘤微环境,其临床活性仍不一致。本综述总结TCR-T治疗实体瘤的生物学基础,包括肽-HLA识别、靶点选择、抗原呈递障碍及肿瘤细胞杀伤机制。随后回顾主要实体瘤类型的当前临床进展,重点介绍特定生物标志物界定人群中具有临床意义的应答,同时指出其在许多上皮癌中的疗效仍有限。现有证据进一步表明,仅有靶点识别不足以实现持久肿瘤控制;持续获益还依赖于抗原呈递得以维持、有效的肿瘤迁移、对抑制信号的抵抗以及T细胞功能状态的保持。
我们还讨论了改善治疗表现的新策略,包括精准受体工程、多HLA靶点开发、针对微环境的功能增强及制备优化。总体而言,TCR-T疗法为实体瘤治疗提供了有吸引力的框架,但要实现更广泛且持久的获益,仍需在靶点选择、安全性设计和细胞工程方面取得综合进展。
T-cell receptor-engineered T-cell (TCR-T) therapy has emerged as a promising strategy for solid tumors because it enables recognition of intracellular antigens presented by human leukocyte antigen (HLA) molecules, thereby extending targetability beyond cell-surface proteins.
However, its clinical activity remains inconsistent because of HLA restriction, heterogeneous antigen expression, unstable antigen presentation, and an immunosuppressive tumor microenvironment. In this review, we summarize the biological basis of TCR-T therapy in solid tumors, including peptide-HLA recognition, target selection, antigen-presentation barriers, and mechanisms of tumor-cell killing.
We then review current clinical progress across major solid tumor types, highlighting meaningful responses in selected biomarker-defined settings while noting that efficacy in many epithelial cancers remains limited. Current evidence further indicates that target recognition alone is insufficient for durable tumor control; sustained benefit also depends on preserved antigen presentation, effective tumor trafficking, resistance to suppressive signals, and maintenance of T-cell fitness.
We also discuss emerging strategies to improve therapeutic performance, including precision receptor engineering, multi-HLA target development, microenvironment-focused armoring, and manufacturing optimization.
Overall, TCR-T therapy provides a compelling framework for solid-tumor treatment, but broader and more durable benefit will require integrated advances in target selection, safety design, and cellular engineering.
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