Domínguez-Prieto Víctor, Qian Siyuan, Villarejo-Campos Pedro, Meliga Cecilia, González-Soares Sara, Guijo Castellano Ismael, Jiménez-Galanes Santos, García-Arranz Mariano, Guadalajara Héctor, García-Olmo Damián
Department of Surgery, Fundación Jimenez Diaz University Hospital, Madrid, Spain.
Department of Surgery, University Hospital Infanta Elena, Madrid, Spain.
Front Oncol. 2023 May 18;13:1104547. doi: 10.3389/fonc.2023.1104547. eCollection 2023.
Ovarian cancer is the seventh most common cancer worldwide in women and the most lethal gynecologic malignancy due to the lack of accurate screening tools for early detection and late symptom onset. The absence of early-onset symptoms often delays diagnosis until the disease has progressed to advanced stages, frequently when there is peritoneal involvement. Although ovarian cancer is a heterogeneous malignancy with different histopathologic types, treatment for advanced tumors is usually based on chemotherapy and cytoreduction surgery. CAR T cells have shown promise for the treatment of hematological malignancies, though their role in treating solid tumors remains unclear. Outcomes are less favorable owing to the low capacity of CAR T cells to migrate to the tumor site, the influence of the protective tumor microenvironment, and the heterogeneity of surface antigens on tumor cells. Despite these results, CAR T cells have been proposed as a treatment approach for peritoneal carcinomatosis from colorectal and gastric origin. Local intraperitoneal administration of CAR T cells has been found to be superior to systemic administration, as this route is associated with increased tumor reduction, a more durable effect, protection against local relapse and distant metastases, and fewer systemic adverse effects. In this article we review the application of CAR T cells for the treatment of ovarian cancer and peritoneal carcinomatosis from ovarian cancer.
卵巢癌是全球女性中第七大常见癌症，也是最致命的妇科恶性肿瘤，原因是缺乏用于早期检测的准确筛查工具且症状出现较晚。早期症状的缺失常常会延迟诊断，直到疾病进展到晚期，通常是出现腹膜受累的时候。尽管卵巢癌是一种具有不同组织病理学类型的异质性恶性肿瘤，但晚期肿瘤的治疗通常基于化疗和细胞减灭术。嵌合抗原受体（CAR）T细胞在治疗血液系统恶性肿瘤方面已显示出前景，但其在治疗实体瘤中的作用仍不明确。由于CAR T细胞迁移至肿瘤部位的能力较低、保护性肿瘤微环境的影响以及肿瘤细胞表面抗原的异质性，治疗结果不太理想。尽管有这些结果，但CAR T细胞已被提议作为治疗结直肠癌和胃癌所致腹膜癌病的一种治疗方法。已发现局部腹腔内给予CAR T细胞优于全身给药，因为这种途径与肿瘤缩小增加、效果更持久、预防局部复发和远处转移以及全身不良反应较少相关。在本文中，我们综述了CAR T细胞在治疗卵巢癌及卵巢癌所致腹膜癌病中的应用。
