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嵌合抗原受体T细胞疗法:管理副作用与克服挑战

CAR-T Cell Therapy: Managing Side Effects and Overcoming Challenges.

作者信息

Golmohammadi Maryam, Noorbakhsh Negar, Kavianpour Maria

机构信息

Department of Applied Cell Sciences and Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Department of Medical Biology, Université du Québec À Trois-Rivières, Trois-Rivières, Québec, Canada.

出版信息

Adv Biomed Res. 2025 Apr 30;14:38. doi: 10.4103/abr.abr_531_23. eCollection 2025.

Abstract

Chimeric antigen receptor T (CAR-T) cell therapy is an innovative and promising approach to treat cancer. Clinical trials have demonstrated remarkable results, providing hope for patients who have exhausted more traditional therapies. However, this new therapy is not without challenges, as significant side effects have been associated with it. Cytokine release syndrome (CRS) is a widely recognized and consequential side effect of CAR-T cell therapy. Neurological toxicity is another potential side effect that can cause confusion and seizures in some patients. Hematologic toxicities, such as anemia and thrombocytopenia, can increase the risk of bleeding or infection. B-cell aplasia can also occur, leading to increased vulnerability to infections. Strategies to reduce the incidence and severity of toxicities include suicide, endogenous, and exogenous switches to modulate the activity of the immune system toward cancer while minimizing toxicity. Despite the obstacles faced by CAR-T cell therapy, continuous research and development in this area offer considerable potential for improving this treatment as a more reliable and efficient method for treating cancer.

摘要

嵌合抗原受体T(CAR-T)细胞疗法是一种创新且有前景的癌症治疗方法。临床试验已显示出显著效果,为那些已用尽更传统疗法的患者带来了希望。然而,这种新疗法并非没有挑战,因为它伴随着严重的副作用。细胞因子释放综合征(CRS)是CAR-T细胞疗法一种广泛认可且后果严重的副作用。神经毒性是另一种潜在副作用,可导致一些患者出现意识混乱和癫痫发作。血液学毒性,如贫血和血小板减少,会增加出血或感染的风险。B细胞发育不全也可能发生,导致对感染的易感性增加。降低毒性发生率和严重程度的策略包括自杀开关、内源性开关和外源性开关,以调节免疫系统针对癌症的活性,同时将毒性降至最低。尽管CAR-T细胞疗法面临诸多障碍,但该领域的持续研发为将这种治疗改进为更可靠、更有效的癌症治疗方法提供了巨大潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eabf/12087935/bfdbbf75bac5/ABR-14-38-g001.jpg

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