, 475 Main Street, New York, NY, 10044, USA.
Department of Pediatrics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box 170, New York, NY, 10065, USA.
Arch Immunol Ther Exp (Warsz). 2018 Aug;66(4):283-288. doi: 10.1007/s00005-018-0507-9. Epub 2018 Feb 9.
Cancer has been ranked as the second leading cause of death in the United States. To reduce cancer mortality, immunotherapy is gaining momentum among other therapeutic modalities, due to its impressive results in clinical trials. The genetically engineered T cells expressing chimeric antigen receptors (CARs) are emerging as a new approach in cancer immunotherapy, with the most successful outcomes in the refractory/relapse hematologic malignancies. However, the widespread clinical applications are limited by adverse effects some of which are life-threatening. Strategies to reduce the chance of side effects as well as close monitoring, rapid diagnosis and proper treatment of side effects are necessary to take the most advantages of this valuable therapy. Here we review the reported toxicities associated with CAR engineered T cells, the strategies to ameliorate the toxicity, and further techniques and designs leading to a safer CAR T-cell therapy.
癌症已被列为美国的第二大死亡原因。为了降低癌症死亡率，免疫疗法由于其在临床试验中的显著效果，在其他治疗方式中逐渐占据优势。表达嵌合抗原受体 (CAR) 的基因工程 T 细胞作为癌症免疫疗法的一种新方法正在兴起，在难治性/复发性血液恶性肿瘤中取得了最成功的结果。然而，由于某些副作用具有致命性，其广泛的临床应用受到限制。为了充分利用这种有价值的治疗方法，有必要降低副作用的几率并密切监测、快速诊断和妥善处理副作用。在这里，我们综述了与 CAR 工程 T 细胞相关的毒性作用、减轻毒性的策略，以及进一步的技术和设计，以实现更安全的 CAR T 细胞治疗。
