Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL 32611, USA.
Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA.
Cells. 2022 Jun 20;11(12):1974. doi: 10.3390/cells11121974.
The promising outcomes of chimeric antigen receptor (CAR) T cell therapy in hematologic malignancies potentiates its capability in the fight against many cancers. Nevertheless, this immunotherapy modality needs significant improvements for the treatment of solid tumors. Researchers have incrementally identified limitations and constantly pursued better CAR designs. However, even if CAR T cells are armed with optimal killer functions, they must overcome and survive suppressive barriers imposed by the tumor microenvironment (TME). In this review, we will discuss in detail the important role of TME in CAR T cell trafficking and how the intrinsic barriers contribute to an immunosuppressive phenotype and cancer progression. It is of critical importance that preclinical models can closely recapitulate the in vivo TME to better predict CAR T activity. Animal models have contributed immensely to our understanding of human diseases, but the intensive care for the animals and unreliable representation of human biology suggest in vivo models cannot be the sole approach to CAR T cell therapy. On the other hand, in vitro models for CAR T cytotoxic assessment offer valuable insights to mechanistic studies at the single cell level, but they often lack in vivo complexities, inter-individual heterogeneity, or physiologically relevant spatial dimension. Understanding the advantages and limitations of preclinical models and their applications would enable more reliable prediction of better clinical outcomes.
嵌合抗原受体 (CAR) T 细胞疗法在血液恶性肿瘤中取得的有前景的结果,使其在对抗多种癌症方面具有潜力。然而,这种免疫疗法需要显著改进,才能用于治疗实体瘤。研究人员逐步确定了局限性,并不断追求更好的 CAR 设计。然而,即使 CAR T 细胞具有最佳的杀伤功能,它们也必须克服并存活于肿瘤微环境 (TME) 施加的抑制性障碍。在这篇综述中,我们将详细讨论 TME 在 CAR T 细胞迁移中的重要作用,以及内在障碍如何导致免疫抑制表型和癌症进展。临床前模型能够很好地重现体内 TME,从而更好地预测 CAR T 细胞的活性,这一点至关重要。动物模型为我们理解人类疾病做出了巨大贡献,但动物的精心护理和对人类生物学的不可靠代表性表明,体内模型不能成为 CAR T 细胞疗法的唯一方法。另一方面,用于 CAR T 细胞细胞毒性评估的体外模型为单细胞水平的机制研究提供了有价值的见解,但它们往往缺乏体内的复杂性、个体间的异质性或生理相关的空间维度。了解临床前模型的优缺点及其应用,将能够更可靠地预测更好的临床结果。