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体内 CAR 免疫细胞工程:在恶性胶质瘤中的未来应用与挑战

英文原题:In Vivo CAR-Based Immune Cell Engineering: Future Applications and Challenges in Malignant Glioma.

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In Vivo CAR-Based Immune Cell Engineering: Future Applications and Challenges in Malignant Glioma.

PubMed 2026/06/18(内容时间) Cancers (Basel) Q2 · IF 4.8(JCR 2025)

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中文摘要

嵌合抗原受体(CAR)T细胞疗法在血液系统恶性肿瘤中取得了显著成功,目前正积极拓展至多种癌症类型。然而,现有CAR-T 疗法依赖体外工程改造,因此存在显著的物流、时间和生物学局限。体内CAR-T 细胞工程正成为一种新范式,可通过给予编码CAR的载体,直接在患者体内重编程免疫细胞,从而有望克服这些挑战。这种方法属于现货型自体免疫疗法。病毒工程和纳米技术的进步推动了多种CAR递送平台的发展;这些平台不仅能递送CAR构建体,还可递送Cas9等基因编辑组分,从而实现更复杂的体内基因改造。部分方法已进入临床评估,并在血液系统恶性肿瘤中显示出早期有希望的结果;实体瘤临床试验也已启动。然而,体内工程CAR-T 疗法在恶性胶质瘤中的应用仍鲜有探索,其面临的挑战与血液系统恶性肿瘤不同。本综述讨论这些挑战及潜在应对策略,并概述体内CAR-T 细胞工程的最新进展。

展开英文摘要原文

Chimeric antigen receptor (CAR)-T cell therapy has achieved remarkable success in hematologic malignancies, and its development is being actively pursued across a broad range of cancer types.

However, current CAR-T cell therapies rely on ex vivo engineering, which presents significant logistical, temporal, and biological limitations. In vivo CAR-T cell engineering is emerging as a new paradigm that may overcome these challenges by enabling the direct reprogramming of immune cells within the patient through the administration of CAR-encoding vectors. This approach represents an off-the-shelf form of autologous immune therapy.

Advances in viral engineering and nanotechnology have enabled the development of diverse CAR delivery platforms that not only deliver CAR constructs but also facilitate the delivery of gene-editing components, such as Cas9, allowing for more sophisticated in vivo genetic modifications. Some of these approaches have already entered clinical evaluation and have shown promising early results in hematologic malignancies, with clinical trials in solid tumors now underway.

However, the application of in vivo-engineered CAR-T cell therapies to malignant glioma remains largely unexplored, reflecting challenges distinct from those encountered in hematologic malignancies. In this review, we discuss these challenges and potential strategies to address them, while highlighting recent progress in in vivo CAR-T cell engineering.

论文信息

作者
Yamaguchi J、Bergquist A、Lu J、Lakshmanachetty S、Khan SH、Okada H
单位
Department of Neurological Surgery, University of California, San Francisco, CA 94158, USA.United States
文献类型
综述
期刊
Cancers2026 Jun 18
原文标识
PubMed 42352518 · DOI 10.3390/cancers18121986