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:Tumour immunotherapy in solid and hematologic malignancies: Progress, challenges, and a practical framework.
肿瘤免疫治疗通过将免疫监视、免疫编辑和检查点生物学的基础见解转化为有效的临床策略,重塑了肿瘤学的格局。
肿瘤免疫治疗通过将免疫监视、免疫编辑和检查点生物学的基础见解转化为有效的临床策略,重塑了肿瘤学的格局。本综述追溯了肿瘤免疫治疗的历史轨迹,从William Coley的早期观察到针对细胞毒性T淋巴细胞相关抗原4(CTLA-4)和程序性细胞死亡蛋白1/配体1(PD-1/PD-L1)的现代免疫检查点抑制剂(ICIs)的发展。此外,还全面分析了免疫治疗在不同肿瘤类型中的进展。在实体瘤中,黑色素瘤、非小细胞肺癌和肾细胞癌等“炎症型”或“热”肿瘤已取得显著获益。然而,在胰腺导管腺癌、胶质母细胞瘤和微卫星稳定型结直肠癌等“非炎症型”或“冷”肿瘤中仍存在巨大障碍。在血液系统恶性肿瘤中,活体药物和重定向免疫治疗已展现出显著疗效:CAR-T疗法在B细胞急性淋巴细胞白血病(B-ALL)和弥漫性大B细胞淋巴瘤(DLBCL)中实现了持久缓解,而T细胞衔接器为多发性骨髓瘤提供了一种快速、“即用型”的选择。总体而言,本综述将这些进展综合为一个基于肿瘤免疫背景的实用框架,为优化当前治疗和指导未来研究以克服耐药并使更多患者获益提供了指南。
Tumour immunotherapy has reshaped the landscape of oncology by translating fundamental insights from immunosurveillance, immunoediting, and checkpoint biology into effective clinical strategies. This review traces the historical trajectory of tumour immunotherapy, from the early observations of William Coley to the development of modern immune checkpoint inhibitors (ICIs) targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and programmed cell death protein 1/ligand 1 (PD-1/PD-L1). Moreover, a comprehensive analysis of the progress of immunotherapy across different tumour types is provided. In solid tumours, significant benefits have been achieved in ``inflamed'' or ``hot'' cancers like melanoma, non-small-cell lung cancer, and renal cell carcinoma. However, formidable hurdles remain in ``non-inflamed'' or ``cold'' tumours such as pancreatic ductal adenocarcinoma, glioblastoma, and microsatellite-stable colorectal cancer. In hematologic malignancies, living drugs and redirecting immunotherapies have demonstrated profound efficacy: CAR-T therapy has achieved durable remissions in B-cell acute lymphoblastic leukemia (B-ALL) and diffuse large B-cell lymphoma (DLBCL), while T-cell engagers offer a rapid, ``off-the-shelf'' option for multiple myeloma. Collectively, this review synthesizes these developments into a practical framework based on tumour immune context, offering a guide for optimizing current treatments and directing future research to overcome resistance and benefit more patients.
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