Cancer Center, The First Hospital of Jilin University, Changchun 130021, China.
Cancer Center, The First Hospital of Jilin University, Changchun 130021, China.
Life Sci. 2020 Nov 1;260:118300. doi: 10.1016/j.lfs.2020.118300. Epub 2020 Aug 20.
Chimeric antigen receptor-modified T cell therapy (CAR-T) is known to exhibit distinctive precision, extensiveness, and persistence in anti-tumor immunity, giving rise to its breakthrough and unprecedented success in hematologic malignancy treatment. On the contrary, this therapy is faced with the inherent obstacles of solid tumors, in which the application of CAR-T is restricted. Smooth infiltration into the tumor microenvironment (TME) is the first critical step. Then, tumor-infiltrating CAR-T cells are forced to overcome the inhibitory effects of miscellaneous factors in the TME and achieve the targeted recognition and killing of tumor cells. Any of these steps, if impeded, can seriously threaten both the efficiency and security of CAR-T therapy. Inspiringly, these challenges have failed to hold back the progress being made by studies focusing on the application of CAR-T in solid tumors. In addition, a growing number of promising coping strategies have gradually emerged. Both the problems and solutions associated with the development and application of these therapeutic strategies are summarized in this review.
嵌合抗原受体修饰的 T 细胞疗法(CAR-T)以其在抗肿瘤免疫方面的独特精确性、广泛性和持久性而闻名,这使其在血液恶性肿瘤治疗方面取得了突破性和前所未有的成功。然而,该疗法在实体肿瘤中面临着固有障碍,限制了 CAR-T 的应用。CAR-T 细胞的顺利浸润是关键的第一步。然后,肿瘤浸润的 CAR-T 细胞必须克服肿瘤微环境(TME)中各种因素的抑制作用,实现对肿瘤细胞的靶向识别和杀伤。这些步骤中的任何一个受到阻碍,都会严重威胁 CAR-T 疗法的效率和安全性。令人鼓舞的是,这些挑战并没有阻止聚焦于 CAR-T 在实体肿瘤应用的研究取得进展。此外,越来越多有前景的应对策略也逐渐出现。本综述总结了与这些治疗策略的开发和应用相关的问题和解决方案。
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