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嵌合抗原受体T细胞疗法的进展与挑战及动物模型的适用性(综述)

Advances and challenges of CAR T therapy and suitability of animal models (Review).

作者信息

Ramos-Cardona Xavier E, Luo Weichuan, Mohammed Sulma I

机构信息

Department of Comparative Pathobiology, Purdue University Center for Cancer Research, West Lafayette, IN 47907, USA.

Department of Chemistry, Purdue University, West Lafayette, IN 47907, USA.

出版信息

Mol Clin Oncol. 2022 Jul 12;17(3):134. doi: 10.3892/mco.2022.2567. eCollection 2022 Sep.

Abstract

Chimeric antigen receptors (CARs) recently gained momentum in cancer treatment due to their ability to promote T-cell mediated responses to a specific tumor-associated antigen. CARs are part of the adoptive cell transfer (ACT) strategies that utilize patients' T lymphocytes, genetically engineered to kill cancer cells. However, despite the therapy's success against blood-related malignancies, treating solid tumors has not reached its fullest potential yet. The reasons include the complex suppressive tumor microenvironment, mutations on cancer cells' target receptors, lethal side-effects, restricted trafficking into the tumor, suboptimal persistence and the lack of animal models that faithfully resemble human tumor's immunological responses. Currently, rodent models are used to investigate the safety and efficacy of CAR therapies. However, these models are limited in representing the human disease faithfully, fail to predict the adverse treatment events and overestimate the efficacy of the therapy. On the other hand, spontaneously developed tumors in dogs are more suited in CAR research and their efficacy has been demonstrated in a number of diseases, including lymphoma, osteosarcoma and mammary tumors. The present review discusses the design and evolution of CARs, challenges of CAR in solid tumors, human and canine clinical trials and advantages of the canine model.

摘要

嵌合抗原受体(CARs)最近在癌症治疗中获得了发展动力,因为它们能够促进T细胞介导的针对特定肿瘤相关抗原的反应。CARs是过继性细胞转移(ACT)策略的一部分,该策略利用经过基因工程改造以杀死癌细胞的患者T淋巴细胞。然而,尽管该疗法在治疗血液系统恶性肿瘤方面取得了成功,但在治疗实体瘤方面尚未发挥出最大潜力。原因包括复杂的肿瘤抑制微环境、癌细胞靶受体的突变、致命的副作用、向肿瘤内的有限转运、欠佳的持久性以及缺乏能如实模拟人类肿瘤免疫反应的动物模型。目前,啮齿动物模型用于研究CAR疗法的安全性和疗效。然而,这些模型在如实反映人类疾病方面存在局限性,无法预测不良治疗事件,并且高估了该疗法的疗效。另一方面,犬类自发形成的肿瘤更适合用于CAR研究,并且其疗效已在包括淋巴瘤、骨肉瘤和乳腺肿瘤在内的多种疾病中得到证实。本综述讨论了CARs的设计与演变、CARs在实体瘤中的挑战、人类和犬类临床试验以及犬类模型的优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cb1/9353808/6bfe56b9fe36/mco-17-03-02567-g00.jpg

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