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推进胶质母细胞瘤 CAR-T 细胞疗法前沿:从临床障碍到突破性策略的现状探索

英文原题:Advancing chimeric antigen receptor T-cell therapy frontiers in glioblastoma: Navigating the current landscape from clinical hurdles to breakthrough strategies.

PubMed 2026/07/24(内容时间) Int Immunopharmacol Q1 · IF 5.6(JCR 2025)

研究概要

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。

中文摘要

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。

展开英文摘要原文

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.

论文信息

作者
Sarma RK、Nath P、Bora P、Chetia P、Bala A
第一作者单位
Department of Pharmacology, NETES Institute of Pharmaceutical Science, NEMCARE Group of Institutions, Guwahati, Kamrup, Assam 781125, India.India
通讯作者单位
Department of Pharmacology, NETES Institute of Pharmaceutical Science, NEMCARE Group of Institutions, Guwahati, Kamrup, Assam 781125, India. Electronic address: purbajit@ngiguwahati.in.India
文献类型
综述
期刊
International immunopharmacology2026 Oct 15
原文标识
PubMed 42497658 · DOI 10.1016/j.intimp.2026.117134