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用于实体瘤的嵌合抗原受体T细胞疗法需要新的临床方案。

Chimeric antigen receptor-T cell therapy for solid tumors require new clinical regimens.

作者信息

Xu Jinjing, Tian Kang, Zhang Haixu, Li Liantao, Liu Hongyan, Liu Jingjie, Zhang Qing, Zheng Junnian

机构信息

a Cancer Institute , Xuzhou Medical University , Xuzhou , Jiangsu , China.

b Galactophore Department , Jiangsu Huai'an Maternity and Children Hospital , Huai'an , Jiangsu , China.

出版信息

Expert Rev Anticancer Ther. 2017 Dec;17(12):1099-1106. doi: 10.1080/14737140.2017.1395285. Epub 2017 Oct 26.

Abstract

Chimeric antigen receptor modified T cell (CAR-T) therapy has achieved encouraging breakthroughs in the treatment of hematological malignancies. Nevertheless, this success has not yet been extrapolated to solid tumors. This review focuses on new clinical regimens that could improve the therapeutic efficacy of CAR-T in solid tumors. Areas covered: Herein, the authors reviewed recent clinical trials using CAR-T therapies for the treatment of solid tumors. Specifically, this review covered the following areas: (1) the current status of CAR-T cells in the treatment of solid tumors; (2) the major factors constraining the efficacy of CAR-T cells in solid tumors; and (3) opinions regarding the future of CAR-T as a treatment for solid tumors. Expert commentary: While some recent studies have shown promising results, the ultimate success of CAR-T therapies in solid tumor patients will require the following improvements to clinical regimens: (1) local delivery of CAR-T cells; (2) combination of CAR-T cells with chemotherapeutic drugs to treat metastatic tumors; (3) combination of CAR-T with immune checkpoint inhibitors; (4) combination therapy using CAR-T cells targeting two different antigens; and (5) the use of CAR-T as a strategy to prevent tumor recurrence and metastasis after radical resection.

摘要

嵌合抗原受体修饰的T细胞(CAR-T)疗法在血液系统恶性肿瘤的治疗中取得了令人鼓舞的突破。然而,这一成功尚未推广到实体瘤的治疗中。本综述聚焦于可提高CAR-T治疗实体瘤疗效的新临床方案。涵盖领域:在此,作者回顾了近期使用CAR-T疗法治疗实体瘤的临床试验。具体而言,本综述涵盖以下领域:(1)CAR-T细胞治疗实体瘤的现状;(2)限制CAR-T细胞治疗实体瘤疗效的主要因素;(3)关于CAR-T作为实体瘤治疗方法的未来展望。专家评论:虽然近期一些研究已显示出有前景的结果,但CAR-T疗法在实体瘤患者中的最终成功将需要对临床方案进行以下改进:(1)CAR-T细胞的局部递送;(2)CAR-T细胞与化疗药物联合治疗转移性肿瘤;(3)CAR-T与免疫检查点抑制剂联合;(4)使用靶向两种不同抗原的CAR-T细胞进行联合治疗;(5)将CAR-T用作根治性切除后预防肿瘤复发和转移的策略。

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