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:Advancing chimeric antigen receptor T-cell therapy frontiers in glioblastoma: Navigating the current landscape from clinical hurdles to breakthrough strategies.
胶质母细胞瘤(GBM)是一种致死性脑肿瘤,标准治疗下预后不佳,其全球发病率不断上升,凸显了对新型治疗方法的迫切需求。
胶质母细胞瘤(GBM)是一种致死性脑肿瘤,在标准治疗下预后不佳,其全球发病率不断上升,凸显了对新型治疗手段的迫切需求。CAR-T(CAR-T)细胞疗法对 GBM 具有前景,但面临独特挑战,包括抗原异质性、深度免疫抑制的肿瘤微环境(TME)、穿越血脑屏障(BBB)的迁移受限以及持久性不足。这篇综合性综述提供了关于 GBM 新兴 CAR-T 策略的整合视角,系统性地概述了正在进行和已完成的试验。它整合了多抗原靶向方法中的创新进展,如双价、串联和多特异性 CAR 构建体,以及增强肿瘤特异性并减轻抗原逃逸的逻辑门控设计。此外,我们讨论了先进的 CAR 工程改造创新,如装甲化细胞因子分泌构建体、代谢重编程以及下一代同种异体平台,包括旨在实现持久性、改进和可扩展性的诱导多能干细胞(iPSC)衍生 CAR-T 细胞技术。与此同时,还探讨了新型递送方法,如局部区域给药、纳米颗粒/聚焦超声 BBB 调控和生物材料支架,以及与检查点抑制剂和溶瘤病毒的合理联合方案。总体而言,这一整合视角为下一代 CAR-T 疗法界定了转化路线图,有望在 GBM 中实现持久且具有临床意义的疗效。
Glioblastoma (GBM) is a lethal brain tumor with poor outcomes under standard therapies, and its rising global incidence underscores the urgent need for novel treatments. Chimeric antigen receptor T (CAR-T) cell therapy holds promise for GBM but faces unique challenges, including antigenic heterogeneity, a profoundly immunosuppressive tumor microenvironment (TME), limited trafficking across the blood brain barrier (BBB), and inadequate persistence. This comprehensive review provides an integrated perspective on emerging CAR-T strategies for GBM, systematically outlining ongoing and completed trials. It integrates innovative advances in multi-antigen targeting approaches such as bivalent, tandem, and multi-specific CAR constructs, as well as logic-gated designs that enhance tumor specificity and mitigate antigen escape. Further, we discuss advanced CAR engineering innovations such as armored cytokine-secreting constructs, metabolic reprogramming, and next-generation allogeneic platforms, including induced pluripotent stem cell (iPSC) derived CAR-T cell technologies aiming for durability, improvement and scalability. In parallel, novel delivery methods such as locoregional administration, nanoparticle/focused-ultrasound BBB modulation, and biomaterial scaffolds are also explored alongside rational combination approaches with checkpoint inhibitors and oncolytic virus. Collectively, this integrated perspective defines a translational roadmap for next generation CAR-T therapies, with the potential to achieve durable and clinically meaningful responses in GBM.
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