Liao Cai-Feng, Lai Hu-Rong, Li Jian
Department of Hematology, Key Laboratory of Hematology, The Second Affiliated Hospital of Nanchang University.Nanchang 330006, Jiangxi Province, China.
Medical College of Nanchang University, Nanchang 330006, Jiangxi Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Aug;32(4):1290-1294. doi: 10.19746/j.cnki.issn.1009-2137.2024.04.048.
The application of chimeric antigen receptor T cell (CAR-T) immunotherapy has ushered in a new era in cancer therapy, especially in the treatment of many kinds of refractory malignant tumors. The curative effect is significant for refractory/recurrent hematologic malignancies, such as acute leukemia, lymphoma, and multiple myeloma (MM). Tumor microenvironment (TME) is closely related to the efficacy and adverse reactions of CAR-T therapy. TME not only affects the activity of CAR-T cells, reduces their anti-tumor ability, but also directly involved in the occurrence and development of CAR-T cell therapy-related adverse reactions, such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Therefore, a deeper understanding of the role of blood TME in the process of CAR-T immunotherapy and the occurrence and development of adverse reactions is helpful for the application of CAR-T therapy in hematological malignancies. In this review, the influence of blood TME on the efficacy and adverse reactions of CAR-T immunotherapy was briefly summarized, aiming to provide evidence-based support for the clinical optimization of therapeutic regimen of refractory/recurrent hematologic malignancies.
嵌合抗原受体T细胞（CAR-T）免疫疗法的应用开创了癌症治疗的新纪元，尤其是在多种难治性恶性肿瘤的治疗中。对于难治性/复发性血液系统恶性肿瘤，如急性白血病、淋巴瘤和多发性骨髓瘤（MM），其疗效显著。肿瘤微环境（TME）与CAR-T疗法的疗效和不良反应密切相关。TME不仅影响CAR-T细胞的活性，降低其抗肿瘤能力，还直接参与CAR-T细胞治疗相关不良反应的发生和发展，如细胞因子释放综合征（CRS）和免疫效应细胞相关神经毒性综合征（ICANS）。因此，深入了解血液TME在CAR-T免疫治疗过程中的作用以及不良反应的发生和发展，有助于CAR-T疗法在血液系统恶性肿瘤中的应用。在本综述中，简要总结了血液TME对CAR-T免疫治疗疗效和不良反应的影响，旨在为难治性/复发性血液系统恶性肿瘤治疗方案的临床优化提供循证支持。
