Immunology Research Center (IRC), Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Pediatric Dentistry, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia.
Stem Cell Res Ther. 2022 Apr 1;13(1):140. doi: 10.1186/s13287-022-02819-x.
Autologous T cells genetically engineered to express chimeric antigen receptor (CAR) have shown promising outcomes and emerged as a new curative option for hematological malignancy, especially malignant neoplasm of B cells. Notably, when T cells are transduced with CAR constructs, composed of the antigen recognition domain of monoclonal antibodies, they retain their cytotoxic properties in a major histocompatibility complex (MHC)-independent manner. Despite its beneficial effect, the current CAR T cell therapy approach faces myriad challenges in solid tumors, including immunosuppressive tumor microenvironment (TME), tumor antigen heterogeneity, stromal impediment, and tumor accessibility, as well as tribulations such as on-target/off-tumor toxicity and cytokine release syndrome (CRS). Herein, we highlight the complications that hamper the effectiveness of CAR T cells in solid tumors and the strategies that have been recommended to overcome these hurdles and improve infused T cell performance.
经基因工程改造表达嵌合抗原受体 (CAR) 的自体 T 细胞已显示出良好的疗效,并成为血液恶性肿瘤(尤其是 B 细胞恶性肿瘤)的一种新的治疗选择。值得注意的是,当 T 细胞被 CAR 构建体转导时,该构建体由单克隆抗体的抗原识别结构域组成,它们以 MHC 非依赖性的方式保留其细胞毒性特性。尽管具有有益的作用,但目前的 CAR T 细胞疗法在实体瘤中面临着诸多挑战,包括免疫抑制性肿瘤微环境 (TME)、肿瘤抗原异质性、基质障碍和肿瘤可及性,以及靶标相关毒性和细胞因子释放综合征 (CRS)等问题。在此,我们重点介绍了阻碍 CAR T 细胞在实体瘤中发挥作用的并发症,以及为克服这些障碍和提高输注 T 细胞性能而推荐的策略。
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