Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Hematology, Wuhan No.1 Hospital, Wuhan, China.
Front Immunol. 2023 Jan 25;14:1063454. doi: 10.3389/fimmu.2023.1063454. eCollection 2023.
Chimeric antigen receptor T-cell (CAR-T-cell) therapy has been well researched to date because of its ability to target malignant tumor cells. The most common CAR-T cells are CD19 CAR-T cells, which play a large role in B-cell leukemia treatment. However, most CAR-T cells are associated with relapse after clinical treatment, so the quality and persistence of CAR-T cells need to be improved. With continuous optimization, there have been four generations of CARs and each generation of CARs has better quality and durability than the previous generation. In addition, it is important to increase the proportion of memory cells in CAR-T cells. Studies have shown that an immunosuppressive tumor microenvironment (TME) can lead to dysfunction of CAR-T cells, resulting in decreased cell proliferation and poor persistence. Thus, overcoming the challenges of immunosuppressive molecules and targeting cytokines in the TME can also improve CAR-T cell persistence. In this paper, we explored how to improve the durability of CAR-T cell therapy by improving the structure of CARs, increasing the proportion of memory CAR-T cells and improving the TME.
嵌合抗原受体 T 细胞(CAR-T 细胞)疗法因其能够靶向恶性肿瘤细胞而备受关注。最常见的 CAR-T 细胞是 CD19 CAR-T 细胞,它在治疗 B 细胞白血病方面发挥了重要作用。然而,大多数 CAR-T 细胞在临床治疗后会出现复发,因此需要提高 CAR-T 细胞的质量和持久性。随着不断优化,已经出现了四代 CAR,每一代 CAR 的质量和耐久性都比上一代更好。此外,提高 CAR-T 细胞中记忆细胞的比例也很重要。研究表明,免疫抑制性肿瘤微环境(TME)会导致 CAR-T 细胞功能障碍,从而导致细胞增殖减少和持久性差。因此,克服 TME 中免疫抑制分子和靶向细胞因子的挑战也可以提高 CAR-T 细胞的持久性。本文探讨了通过改进 CAR 的结构、增加记忆性 CAR-T 细胞的比例以及改善 TME 来提高 CAR-T 细胞治疗的持久性。
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