嵌合抗原受体 T 细胞在神经胶质瘤中的应用:现状与展望

Chimeric Antigen Receptor T Cells in Glioblastoma-Current Concepts and Promising Future.

机构信息

Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.

出版信息

Cells. 2023 Jul 3;12(13):1770. doi: 10.3390/cells12131770.

Abstract

Glioblastoma (GBM) is a highly aggressive primary brain tumor that is largely refractory to treatment and, therefore, invariably relapses. GBM patients have a median overall survival of 15 months and, given this devastating prognosis, there is a high need for therapy improvement. One of the therapeutic approaches currently tested in GBM is chimeric antigen receptor (CAR)-T cell therapy. CAR-T cells are genetically altered T cells that are redirected to eliminate tumor cells in a highly specific manner. There are several challenges to CAR-T cell therapy in solid tumors such as GBM, including restricted trafficking and penetration of tumor tissue, a highly immunosuppressive tumor microenvironment (TME), as well as heterogeneous antigen expression and antigen loss. In addition, CAR-T cells have limitations concerning safety, toxicity, and the manufacturing process. To date, CAR-T cells directed against several target antigens in GBM including interleukin-13 receptor alpha 2 (IL-13Rα2), epidermal growth factor receptor variant III (EGFRvIII), human epidermal growth factor receptor 2 (HER2), and ephrin type-A receptor 2 (EphA2) have been tested in preclinical and clinical studies. These studies demonstrated that CAR-T cell therapy is a feasible option in GBM with at least transient responses and acceptable adverse effects. Further improvements in CAR-T cells regarding their efficacy, flexibility, and safety could render them a promising therapy option in GBM.

摘要

胶质母细胞瘤(GBM)是一种高度侵袭性的原发性脑肿瘤,对治疗基本无反应,因此总是会复发。GBM 患者的总体中位生存期为 15 个月,鉴于这种毁灭性的预后,非常需要改善治疗方法。目前在 GBM 中测试的一种治疗方法是嵌合抗原受体(CAR)-T 细胞疗法。CAR-T 细胞是经过基因改造的 T 细胞,能够以高度特异性的方式定向消除肿瘤细胞。在 GBM 等实体瘤中,CAR-T 细胞疗法面临着一些挑战,包括肿瘤组织的受限迁移和穿透、高度免疫抑制的肿瘤微环境(TME)以及异质抗原表达和抗原丢失。此外,CAR-T 细胞在安全性、毒性和制造过程方面存在局限性。迄今为止,针对 GBM 中的几种靶抗原(包括白细胞介素 13 受体 alpha 2(IL-13Rα2)、表皮生长因子受体变体 III(EGFRvIII)、人表皮生长因子受体 2(HER2)和 Ephrin 型-A 受体 2(EphA2)的 CAR-T 细胞已在临床前和临床研究中进行了测试。这些研究表明,CAR-T 细胞疗法是 GBM 的一种可行选择,至少有短暂的反应和可接受的不良反应。进一步提高 CAR-T 细胞的疗效、灵活性和安全性可以使它们成为 GBM 中一种有前途的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/006f/10340625/151634e6247d/cells-12-01770-g001.jpg

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