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:Next-generation CAR-NK cell therapy: engineering strategies, translational challenges, and future perspectives in cancer immunotherapy.
自然杀伤(NK)细胞在固有免疫监视中发挥核心作用,是下一代癌症免疫治疗颇具前景的平台。
自然杀伤(NK)细胞是先天免疫监视的核心组成,也为下一代癌症免疫治疗提供了有前景的平台。近期嵌合抗原受体(CAR)工程技术进展推动CAR-NK细胞疗法发展,使其有望成为比CAR-T更安全、可及性更好的替代方案。与CAR-T相比,CAR-NK发生细胞因子释放综合征和移植物抗宿主病的风险较低,并有望制备成异基因“现货型”产品。临床前及早期临床研究显示,CAR-NK在血液系统恶性肿瘤和实体瘤中均具有令人鼓舞的抗肿瘤活性。然而,体内持久性有限、肿瘤迁移不足、肿瘤免疫微环境抑制、制造差异及长期临床数据有限等转化挑战仍待解决。为克服这些障碍,研究者正积极探索CRISPR基因编辑、细胞因子装甲型CAR构建体、多重工程化、联合免疫检查点阻断及溶瘤病毒策略。本综述更新CAR-NK细胞生物学、工程策略、当前临床进展、主要转化挑战及未来治疗机遇,并讨论可能改善持久性、安全性和疗效的新型联合方法及下一代工程策略,以推动CAR-NK免疫治疗更广泛地转化至临床。
Natural killer (NK) cells play a central role in innate immune surveillance and represent a promising platform for next-generation cancer immunotherapy. Recent advances in chimeric antigen receptor (CAR) engineering have accelerated the development of CAR-NK cell therapies as potentially safer and more accessible alternatives to CAR-T cell therapy. Compared with CAR-T cells, CAR-NK therapies demonstrate lower risks of cytokine release syndrome and graft-versus-host disease while offering the potential for allogeneic "off-the-shelf" applications. Preclinical and early-phase clinical studies have shown encouraging antitumor activity of CAR-NK cells in both hematological malignancies and solid tumors. However, several translational challenges remain, including limited in vivo persistence, insufficient tumor trafficking, immunosuppressive tumor immune microenvironments, manufacturing variability, and restricted long-term clinical data. To overcome these barriers, emerging strategies such as CRISPR-based gene editing, cytokine-armored CAR constructs, multiplex engineering, checkpoint blockade combinations, and oncolytic virus-based approaches are being actively investigated. This review provides an updated overview of CAR-NK cell biology, engineering strategies, current clinical progress, major translational challenges, and future therapeutic opportunities. In addition, we discuss evolving combinatorial and next-generation engineering approaches that may improve persistence, safety, and therapeutic efficacy, ultimately facilitating the broader clinical translation of CAR-NK immunotherapy.
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