Experimental Hematology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
Semin Immunopathol. 2024 Jul 25;46(3-4):8. doi: 10.1007/s00281-024-01011-y.
Adoptive cell therapy (ACT) using Chimeric Antigen Receptor (CAR) and T Cell Receptor (TCR) engineered T cells represents an innovative therapeutic approach for the treatment of hematological malignancies, yet its application for solid tumors is still suboptimal. The tumor microenvironment (TME) places several challenges to overcome for a satisfactory therapeutic effect, such as physical barriers (fibrotic capsule and stroma), and inhibitory signals impeding T cell function. Some of these obstacles can be faced by combining ACT with other anti-tumor approaches, such as chemo/radiotherapy and checkpoint inhibitors. On the other hand, cutting edge technological tools offer the opportunity to overcome and, in some cases, take advantage of TME intrinsic characteristics to boost ACT efficacy. These include: the exploitation of chemokine gradients and integrin expression for preferential T-cell homing and extravasation; metabolic changes that have direct or indirect effects on TCR-T and CAR-T cells by increasing antigen presentation and reshaping T cell phenotype; introduction of additional synthetic receptors on TCR-T and CAR-T cells with the aim of increasing T cells survival and fitness.
嵌合抗原受体(CAR)和 T 细胞受体(TCR)工程化 T 细胞的过继细胞疗法(ACT)代表了治疗血液恶性肿瘤的一种创新治疗方法,但在实体瘤中的应用仍不尽如人意。肿瘤微环境(TME)给治疗效果带来了诸多挑战,例如物理屏障(纤维囊和基质)以及抑制性信号抑制 T 细胞功能。可以通过将 ACT 与化疗/放疗和检查点抑制剂等其他抗肿瘤方法相结合来应对其中一些障碍。另一方面,前沿技术工具为克服某些情况下利用 TME 内在特征来提高 ACT 疗效提供了机会。这些包括:利用趋化因子梯度和整合素表达促进 T 细胞归巢和渗出;代谢变化通过增加抗原呈递和重塑 T 细胞表型,对 TCR-T 和 CAR-T 细胞产生直接或间接影响;在 TCR-T 和 CAR-T 细胞上引入额外的合成受体,以提高 T 细胞的存活和适应性。
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