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结直肠癌免疫疗法的进展:从嵌合抗原受体T细胞到基于外泌体的疗法。

Advancements in colorectal cancer immunotherapy: from CAR-T cells to exosome-based therapies.

作者信息

Arabi Sepideh, Fadaee Manouchehr, Kazemi Tohid, Rahmani Mohammadreza

机构信息

Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran.

出版信息

J Drug Target. 2025 Jun;33(5):749-760. doi: 10.1080/1061186X.2024.2449482. Epub 2025 Jan 8.

Abstract

Colorectal cancer (CRC) continues to be a major worldwide health issue, with elevated death rates linked to late stages of the illness. Immunotherapy has made significant progress in developing effective techniques to improve the immune system's capacity to identify and eradicate cancerous cells. This study examines the most recent advancements in CAR-T cell treatment and exosome-based immunotherapy for CRC. CAR-T cell therapy, although effective in treating blood cancers, encounters obstacles when used against solid tumours such as CRC. These obstacles include the presence of an immunosuppressive tumour microenvironment and a scarcity of tumour-specific antigens. Nevertheless, novel strategies like dual-receptor CAR-T cells and combination therapy involving cytokines have demonstrated promise in surmounting these obstacles. Exosome-based immunotherapy is a promising approach for targeted delivery of therapeutic drugs to tumour cells, with high specificity and minimal off-target effects. However, there are still obstacles to overcome in the field, such as resistance to treatment, adverse effects associated with the immune system, and the necessity for more individualised methods. The current research is focused on enhancing these therapies, enhancing the results for patients, and ultimately incorporating these innovative immunotherapeutic approaches into the standard treatment protocols for CRC.

摘要

结直肠癌(CRC)仍然是一个全球性的重大健康问题,其死亡率升高与疾病的晚期阶段相关。免疫疗法在开发有效技术以提高免疫系统识别和根除癌细胞的能力方面取得了重大进展。本研究探讨了嵌合抗原受体T细胞(CAR-T)治疗和基于外泌体的免疫疗法在CRC治疗中的最新进展。CAR-T细胞疗法虽然在治疗血液癌症方面有效,但在用于治疗像CRC这样的实体瘤时会遇到障碍。这些障碍包括免疫抑制性肿瘤微环境的存在以及肿瘤特异性抗原的缺乏。然而,双受体CAR-T细胞等新策略以及涉及细胞因子的联合疗法已显示出克服这些障碍的潜力。基于外泌体的免疫疗法是一种将治疗药物靶向递送至肿瘤细胞的有前景的方法,具有高特异性和最小的脱靶效应。然而,该领域仍有障碍需要克服,如治疗抗性、与免疫系统相关的不良反应以及对更个性化方法的需求。当前的研究集中在改进这些疗法,提高患者的治疗效果,并最终将这些创新的免疫治疗方法纳入CRC的标准治疗方案中。

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