Clinical Pharmacology, Modeling & Simulation, Amgen Inc., South San Francisco, California, USA.
Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, Amarillo, Texas, USA.
Clin Transl Sci. 2022 Sep;15(9):2057-2074. doi: 10.1111/cts.13349. Epub 2022 Jul 2.
Advances in immuno-oncology have provided a variety of novel therapeutics that harness the innate immune system to identify and destroy neoplastic cells. It is noteworthy that acceptable safety profiles accompany the development of these targeted therapies, which result in efficacious cancer treatment with higher survival rates and lower toxicities. Adoptive cellular therapy (ACT) has shown promising results in inducing sustainable remissions in patients suffering from refractory diseases. Two main types of ACT include engineered Chimeric Antigen Receptor (CAR) T cells and T cell receptor (TCR) T cells. The application of these immuno-therapies in the last few years has been successful and has demonstrated a safe and rapid treatment regimen for solid and non-solid tumors. The current review presents an insight into the clinical pharmacology aspects of immuno-therapies, especially CAR-T cells. Here, we summarize the current knowledge of TCR and CAR-T cell immunotherapy with particular focus on the structure of CAR-T cells, the effects and toxicities associated with these therapies in clinical trials, risk mitigation strategies, dose selection approaches, and cellular kinetics. Finally, the quantitative approaches and modeling techniques used in the development of CAR-T cell therapies are described.
免疫肿瘤学的进展提供了多种新型疗法,这些疗法利用先天免疫系统来识别和破坏肿瘤细胞。值得注意的是,这些靶向疗法的开发伴随着可接受的安全性概况,它们为患有难治性疾病的患者提供了有效的癌症治疗,具有更高的生存率和更低的毒性。过继性细胞疗法(ACT)在诱导患者持续缓解方面显示出了有前途的结果。ACT 的两种主要类型包括工程化嵌合抗原受体(CAR)T 细胞和 T 细胞受体(TCR)T 细胞。这些免疫疗法在过去几年中的应用取得了成功,并为实体瘤和非实体瘤展示了一种安全快速的治疗方案。本综述介绍了免疫疗法,特别是 CAR-T 细胞的临床药理学方面的内容。在这里,我们总结了 TCR 和 CAR-T 细胞免疫疗法的现有知识,特别关注 CAR-T 细胞的结构、临床试验中与这些疗法相关的作用和毒性、风险缓解策略、剂量选择方法和细胞动力学。最后,描述了在 CAR-T 细胞疗法开发中使用的定量方法和建模技术。