肿瘤细胞治疗研究
英文原题：Chimeric Antigen Receptor-T Cells Fate after Infusion: Cellular Kinetics and Molecular Monitoring.
然而，CAR-T 细胞治疗的疗效差异很大，约 30% 至 50% 的接受治疗患者在输注后出现复发。
嵌合抗原受体（CAR）T细胞被视为人类基因治疗产品，通过基因修饰T淋巴细胞，使其识别特定靶抗原以发挥治疗作用。CAR-T疗法治疗血液系统肿瘤取得显著成功；迄今，美国食品药品监督管理局（FDA）已批准6种商业产品，用于复发/难治性B细胞恶性肿瘤。由于CAR-T治疗存在显著毒性，主要包括细胞因子释放综合征和神经毒性，因此通常仅用于疾病晚期、既往治疗无应答且无其他治疗选择的患者。然而，CAR-T疗效存在较大差异，约30%–50%的患者治疗后复发。CAR构建体类型、制造流程、输注细胞量、改造T细胞质量及患者肿瘤负荷等多种因素，均可能影响CAR-T细胞命运和疗效。本综述重点关注输注后分子监测及可能发生的失控事件，包括插入突变、克隆性T细胞扩增或继发性T细胞淋巴瘤。
Chimeric antigen receptor (CAR) T cells are considered human gene therapy products in which T lymphocytes are genetically modified to recognize a specific target antigen for therapeutic purposes. CAR-T cell therapy has shown particular success in the treatment of hematological neoplasms and, to date, the FDA has approved six commercial products for the treatment of relapsed/refractory B-cell malignancies. Because CAR-T cell therapy is associated with considerable toxicities, mainly cytokine release syndrome and neurological toxicity, it is reserved for patients with advanced-stage disease who have not responded to previous therapies and have no other treatment options. However, the efficacy of CAR-T cell therapy is highly variable, and approximately 30% to 50% of treated patients experience relapse after administration. Several variables, including the type of CAR construct, manufacturing procedure, infusion volume, quality of the manipulated T cells, and the patient's tumor burden, may influence the fate and efficacy of CAR-T cells. In this review, specific attention is focused on molecular monitoring after infusion and on the potential occurrence of uncontrolled events, such as insertional mutagenesis, clonal T-cell expansion, or the onset of secondary T-cell lymphomas.
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