抑制性免疫微环境与嵌合抗原受体 T 细胞疗法治疗胶质母细胞瘤:未来展望与挑战。

Suppressive immune microenvironment and CART therapy for glioblastoma: Future prospects and challenges.

机构信息

Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong Cancer Hospital and Institute, Jinan, Shandong, China.

Department of Radiation Oncology, Affiliated Tumor Hospital of Xinjiang Medical University, China.

出版信息

Cancer Lett. 2024 Sep 28;600:217185. doi: 10.1016/j.canlet.2024.217185. Epub 2024 Aug 12.

Abstract

Glioblastoma, a highly malignant intracranial tumor, has acquired slow progress in treatment. Previous clinical trials involving targeted therapy and immune checkpoint inhibitors have shown no significant benefits in treating glioblastoma. This ineffectiveness is largely due to the complex immunosuppressive environment of glioblastoma. Glioblastoma cells exhibit low immunogenicity and strong heterogeneity and the immune microenvironment is replete with inhibitory cytokines, numerous immunosuppressive cells, and insufficient effective T cells. Fortunately, recent Phase I clinical trials of CART therapy for glioblastoma have confirmed its safety, with a small subset of patients achieving survival benefits. However, CART therapy continues to face challenges, including blood-brain barrier obstruction, antigen loss, and an immunosuppressive tumor microenvironment (TME). This article provides a detailed examination of glioblastoma's immune microenvironment, both from intrinsic and extrinsic tumor cell factors, reviews current clinical and basic research on multi-targets CART treatment, and concludes by outlining the key challenges in using CART cells for glioblastoma therapy.

摘要

胶质母细胞瘤是一种高度恶性的颅内肿瘤,在治疗方面进展缓慢。之前的靶向治疗和免疫检查点抑制剂的临床试验并未显示出对胶质母细胞瘤治疗有显著益处。这种无效性主要归因于胶质母细胞瘤复杂的免疫抑制环境。胶质母细胞瘤细胞表现出低免疫原性和强异质性,免疫微环境中充满了抑制性细胞因子、大量的免疫抑制细胞和不足的有效 T 细胞。幸运的是,最近针对胶质母细胞瘤的嵌合抗原受体 T 细胞(CART)疗法的 I 期临床试验证实了其安全性,一小部分患者获得了生存获益。然而,CART 疗法仍然面临挑战,包括血脑屏障阻塞、抗原丢失和免疫抑制的肿瘤微环境(TME)。本文详细检查了胶质母细胞瘤的免疫微环境,包括内在和外在肿瘤细胞因素,回顾了目前针对多靶点 CART 治疗的临床和基础研究,并总结了使用 CART 细胞治疗胶质母细胞瘤的关键挑战。

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