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:Beyond the chimeric antigen receptor T cells and bispecific antibody duopoly: ex vivo armed T cells for solid tumors.
尽管单克隆抗体(mAb)继续主导整体免疫治疗格局,基于 T 细胞的治疗领域正在迅速发展。
尽管单克隆抗体(mAb)仍主导整体免疫治疗领域,T细胞疗法正迅速发展。CAR-T 细胞和双特异性抗体(BsAb)目前是T细胞靶向治疗的支柱,但实体瘤的复杂性要求更丰富多样的治疗手段。BsAb装载T细胞(BAT,也称离体装载T细胞,EAT)将抗体介导的肿瘤靶向与离体扩增T细胞强大的效应功能相结合,为实体瘤免疫治疗提供“第三条路径”,以应对尚未满足的临床需求。这些细胞可弥补癌症患者内源性免疫效应细胞在数量和质量上的不足。EAT具备个体化多抗原靶向能力,并有望实现现货型治疗,因此可能应对多项关键挑战,包括肿瘤浸润不足、由异质性及靶抗原丢失导致的免疫逃逸,以及细胞因子释放综合征等治疗相关毒性。本综述讨论EAT疗法的特征,将其作为区别于CAR-T和BsAb的独立替代治疗方向;并探讨加速其临床转化的策略,包括优化BsAb、调节肿瘤微环境(TME)和细胞因子,以及同时靶向多种抗原,以增强EAT效力并克服实体瘤的限制。在这一不断发展的领域,EAT有望发挥独特且独立的作用,拓展由CAR-T和BsAb主导的治疗格局,满足尚未解决的临床需求。
While monoclonal antibodies (mAbs) continue to dominate the overall immunotherapy landscape, the field of T-cell-based therapeutics is rapidly evolving. Although chimeric antigen receptor T cells (CAR-T) and bispecific antibodies (BsAbs) currently represent the pillars of T-cell-directed therapy, the complexity of solid tumors demands a more diversified therapeutic arsenal. By combining antibody-mediated tumor targeting with the robust effector function of ex vivo expanded T cells, BsAb-armed T cells (BATs)-also referred to as Ex vivo Armed T cell (EATs)-provide a 'third way' that addresses the unmet needs of solid tumor immunotherapy. They can overcome the quantitative and qualitative deficiencies of endogenous immune effector cells in cancer patients. By offering personalized multi-antigen targetability and the prospect of off-the-shelf therapy, EATs have the potential to address critical challenges, such as poor tumor infiltration, immune escape via heterogeneity and target antigen loss, and treatment-related toxicities like cytokine release syndrome. In this review, we discuss the characteristics of EAT therapy, distinct from CAR-T and BsAb therapy, as an independent and alternative niche. We explore strategies to accelerate their clinical translation, encompassing BsAb optimization, modulation of the tumor microenvironment (TME) and cytokines, and simultaneous engagement of multiple antigens, which are essential for boosting EAT potency and overcoming the limitations of solid tumors. In this evolving landscape, EATs could play a unique and independent role, expanding the CAR-T and BsAb-dominated paradigm to address unmet clinical needs.
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