School of Paramedicine, Guilan University of Medical Sciences, Rasht, Iran.
University of Notre Dame Australia, Sydney, Australia.
Clin Exp Med. 2023 Dec;23(8):4431-4447. doi: 10.1007/s10238-023-01177-z. Epub 2023 Sep 1.
Cancer remains a major health problem despite numerous new medical interventions that have been introduced in recent years. One of the major choices for cancer therapy is so-called adoptive cell therapy (ACT). ACT can be performed using both innate immune cells, including dendritic cells (DCs), natural killer (NK) cells, and γδ T cells and acquired immune T cells. It has become possible to utilize these cells in both their native and modified states in clinical studies. Because of considerable success in cancer treatment, ACT now plays a role in advanced therapy protocols. Genetic engineering of autologous and allogeneic immune cells (T lymphocytes, NK cells, macrophages, etc.) with chimeric antigen receptors (CAR) is a powerful new tool to target specific antigens on cancer cells. The Food and Drug Administration (FDA) in the US has approved certain CAR-T cells for hematologic malignancies and it is hoped that their use can be extended to incorporate a variety of cells, in particular NK cells. However, the ACT method has some limitations, such as the risk of rejection in allogeneic engrafts. Accordingly, numerous efforts are being made to eliminate or minimize this and other complications. In the present review, we have developed a guide to breast cancer (BC) therapy from conventional therapy, through to cell-based approaches, in particular novel technologies including CAR with emphasis on NK cells as a new and safer candidate in this field as well as the more recent aptamer technology, which can play a major role in BC immunotherapy.
尽管近年来引入了许多新的医学干预措施,癌症仍然是一个主要的健康问题。癌症治疗的主要选择之一是所谓的过继细胞疗法 (ACT)。ACT 可以使用固有免疫细胞,包括树突状细胞 (DC)、自然杀伤 (NK) 细胞和 γδ T 细胞,以及获得性免疫 T 细胞来进行。在临床研究中已经可以利用这些细胞的天然和修饰状态。由于在癌症治疗方面取得了相当大的成功,ACT 现在在先进的治疗方案中发挥作用。嵌合抗原受体 (CAR) 对自体和同种异体免疫细胞(T 淋巴细胞、NK 细胞、巨噬细胞等)的基因工程是一种针对癌细胞特定抗原的强大新工具。美国食品和药物管理局 (FDA) 已批准某些 CAR-T 细胞用于血液恶性肿瘤,人们希望将其用途扩展到包括各种细胞,特别是 NK 细胞。然而,ACT 方法存在一些限制,例如同种异体移植物排斥的风险。因此,正在做出许多努力来消除或最小化这种风险和其他并发症。在本综述中,我们从常规治疗到基于细胞的方法,为乳腺癌 (BC) 治疗制定了指南,特别是包括 CAR 的新技术,重点是 NK 细胞作为该领域的一种新的、更安全的候选细胞,以及最近的适体技术,该技术可以在 BC 免疫治疗中发挥重要作用。