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嵌合抗原受体 T 细胞基因治疗癌症:新视角、新挑战和临床新进展。

CAR T-Cell-Based gene therapy for cancers: new perspectives, challenges, and clinical developments.

机构信息

Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, United States.

Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.

出版信息

Front Immunol. 2022 Jul 22;13:925985. doi: 10.3389/fimmu.2022.925985. eCollection 2022.

Abstract

Chimeric antigen receptor (CAR)-T cell therapy is a progressive new pillar in immune cell therapy for cancer. It has yielded remarkable clinical responses in patients with B-cell leukemia or lymphoma. Unfortunately, many challenges remain to be addressed to overcome its ineffectiveness in the treatment of other hematological and solidtumor malignancies. The major hurdles of CAR T-cell therapy are the associated severe life-threatening toxicities such as cytokine release syndrome and limited anti-tumor efficacy. In this review, we briefly discuss cancer immunotherapy and the genetic engineering of T cells and, In detail, the current innovations in CAR T-cell strategies to improve efficacy in treating solid tumors and hematologic malignancies. Furthermore, we also discuss the current challenges in CAR T-cell therapy and new CAR T-cell-derived nanovesicle therapy. Finally, strategies to overcome the current clinical challenges associated with CAR T-cell therapy are included as well.

摘要

嵌合抗原受体 (CAR)-T 细胞疗法是癌症免疫细胞疗法的一个新的重要支柱。它在治疗 B 细胞白血病或淋巴瘤患者方面取得了显著的临床疗效。不幸的是,为了克服其在治疗其他血液系统和实体瘤恶性肿瘤方面的无效性,仍有许多挑战需要解决。CAR T 细胞疗法的主要障碍是相关的严重危及生命的毒性,如细胞因子释放综合征和有限的抗肿瘤疗效。在这篇综述中,我们简要讨论了癌症免疫疗法和 T 细胞的基因工程,并详细介绍了 CAR T 细胞策略的当前创新,以提高治疗实体瘤和血液恶性肿瘤的疗效。此外,我们还讨论了 CAR T 细胞治疗目前面临的挑战和新的 CAR T 细胞衍生的纳米囊泡治疗。最后,还包括克服与 CAR T 细胞治疗相关的当前临床挑战的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31af/9355792/351271a65f06/fimmu-13-925985-g001.jpg

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