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胶质母细胞瘤的 CAR-T 细胞治疗:障碍与进展

英文原题:CAR-T Cell Therapy for Glioblastoma: Obstacles and Advances.

查看英文原题

CAR-T Cell Therapy for Glioblastoma: Obstacles and Advances.

PubMed 2026/08/21(内容时间) Crit Rev Oncol Hematol Q1 · IF 6.2(JCR 2025)

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中文摘要

胶质母细胞瘤(GBM)是中枢神经系统最具侵袭性的原发恶性肿瘤。CAR-T(CAR-T)细胞疗法在针对GBM方面已展现出有前景的治疗潜力,但其疗效仍受到多重屏障的制约,包括血脑屏障和细胞外基质构成的物理屏障、免疫抑制性肿瘤微环境、时空抗原异质性以及安全性问题。在本综述中,我们总结了限制CAR-T 疗法在GBM中应用的主要障碍,并讨论了克服这些挑战的新兴策略。下一代工程化CAR-T 细胞——通过装甲化修饰、逻辑门控调控和双靶向策略——增强了特异性、持久性和可控性。与此同时,利用生物材料的联合策略可实现CAR-T 细胞的局部递送与持续释放,而聚焦超声和热调控等物理手段则可瞬时破坏血脑屏障或诱导免疫原性细胞死亡。与实时成像的整合进一步实现了对治疗反应的动态监测。总之,这些协同策略可能在增强抗肿瘤疗效的同时最大限度地降低全身毒性,为未来基于CAR-T 的胶质母细胞瘤治疗铺平道路。

展开英文摘要原文

Glioblastoma (GBM) is the most aggressive primary malignancy of the central nervous system. Chimeric antigen receptor T (CAR-T) cell therapy has shown promising therapeutic potential against GBM, yet its efficacy remains constrained by multiple barriers, including physical barriers imposed by the blood-brain barrier and extracellular matrix, the immunosuppressive tumor microenvironment, spatiotemporal antigen heterogeneity, and safety concerns. In this review, we summarize the major obstacles limiting CAR-T therapy in GBM and discuss emerging strategies to overcome these challenges.

Next-generation engineered CAR-T cells-through armored modifications, logic-gated regulation, and dual-targeting approaches-enhance specificity, persistence, and controllability.

Concurrently, combinatorial approaches leveraging biomaterials enable localized delivery and sustained release of CAR-T cells, while physical modalities, such as focused ultrasound and thermal modulation, can transiently disrupt the blood-brain barrier or induce immunogenic cell death. Integration with real-time imaging further enables dynamic monitoring of therapeutic responses.

Together, these synergistic strategies may enhance antitumor efficacy while minimizing systemic toxicity, paving the way for future CAR-T-based therapies in glioblastoma.

论文信息

作者
Chen L、Zou Z
第一作者单位
Cancer Center, Hubei Key Laboratory of Precision Radiation Oncology, Institute of Radiation Oncology, Hubei International Scientific and Technological Cooperation Base of Precision Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China; Key Laboratory of Biological Targeted Therapy (Huazhong University of Science and Technology), Ministry of Education, Wuhan, Hubei 430022, China.China
通讯作者单位
Cancer Center, Hubei Key Laboratory of Precision Radiation Oncology, Institute of Radiation Oncology, Hubei International Scientific and Technological Cooperation Base of Precision Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China; Key Laboratory of Biological Targeted Therapy (Huazhong University of Science and Technology), Ministry of Education, Wuhan, Hubei 430022, China. Electronic address: zouzhenwei@hust.edu.cn.China
文献类型
综述
期刊
Critical reviews in oncology/hematology2026 Aug 21
原文标识
PubMed 42628610 · DOI 10.1016/j.critrevonc.2026.105556