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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Cognitive dysfunction associated with cellular immunotherapy for cancer.
Cognitive dysfunction associated with cellular immunotherapy for cancer.
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免疫疗法可调动个体自身免疫系统对抗血液系统及实体恶性肿瘤,并使许多患者获得持久临床应答。T细胞衔接器(TCE)和CAR-T 细胞疗法等免疫疗法亚类通过T细胞介导机制诱导癌细胞死亡。这些疗法可有效对抗癌症,但也可能造成显著全身性及神经系统毒性,包括认知功能障碍。本文回顾现有及新兴文献,介绍CAR-T 和其他T细胞衔接疗法对认知功能的急性、亚急性及潜在长期影响。尽管认知方面的急性影响,包括免疫效应细胞相关神经毒性综合征,正得到更充分描述,但T细胞免疫疗法后的长期主观和客观认知结局证据仍不一致。随着这些有前景且有效的疗法越来越多地用于血液系统和实体恶性肿瘤,仍需进一步研究。
Immunotherapies engage the individual's immune system to fight both hematologic and solid malignancies and have led to durable clinical responses for many patients. A subset of immunotherapies, including T cell engagers (TCEs) and chimeric antigen receptor T-cell therapies (CAR-T), use T cell mediated mechanisms to induce cancer cell death. These therapies can be very effective against the cancer while also causing significant systemic and neurologic toxicity, including cognitive dysfunction.
Here, we provide a review on the existing and emerging literature describing the acute, subacute, and potential long-term effects of CAR-T cells and other T-cell-engaging therapies on cognition. While the acute effects on cognition, including immune effector cell-associated neurotoxicity syndrome are becoming better characterized, there is mixed data on the long-term subjective and objective cognitive outcomes after T-cell-based immunotherapies.
Further research is needed, especially as these promising and effective therapies become more commonly used for both hematologic and solid malignancies.
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