Zhang Wan-Ying, Yang Lang-Yu, Fan Xing-Xing
Dr. Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, School of Chinese Medicine, Macau University of Science and Technology, Macau, Macau SAR, China.
Front Immunol. 2025 Jul 2;16:1622433. doi: 10.3389/fimmu.2025.1622433. eCollection 2025.
Chimeric antigen receptor T (CAR-T) cell therapy has revolutionized the treatment landscape for hematologic malignancies; however, its efficacy in solid tumors remains limited due to antigen heterogeneity, a suppressive tumor microenvironment, and tumor-intrinsic resistance mechanisms. In parallel, immune checkpoint blockade (ICB) therapies have achieved clinical milestones but often fail due to impaired antigen presentation, interferon signaling dysregulation, and immune exclusion. Recent advances in CAR-T therapy-based technologies including multi-specific and armored CAR constructs, gene-editing strategies, and synthetic circuits offer new opportunities to overcome these barriers and expand therapeutic efficacy. Artificial intelligence (AI) has further accelerated the discovery of novel tumor antigens, optimized CAR design, and enabled real-time modeling of treatment responses. Integration of CAR-T therapy with AI-driven platforms, metabolic reprogramming, bispecific antibodies, and advanced single-cell analytics represents a powerful strategy to enhance tumor targeting and durability of response. This review summarizes emerging CAR-T therapy-based innovations, explores their synergistic applications with immunotherapies, and discusses current challenges related to safety, manufacturing, cost, and biomarker validation. These multidisciplinary efforts collectively pave the way toward more effective and personalized cancer treatment.
嵌合抗原受体T(CAR-T)细胞疗法彻底改变了血液系统恶性肿瘤的治疗格局;然而,由于抗原异质性、抑制性肿瘤微环境和肿瘤内在抗性机制,其在实体瘤中的疗效仍然有限。与此同时,免疫检查点阻断(ICB)疗法取得了临床里程碑式的进展,但由于抗原呈递受损、干扰素信号失调和免疫排斥,往往会失败。基于CAR-T疗法的技术,包括多特异性和武装CAR构建体、基因编辑策略和合成电路,最近的进展为克服这些障碍和扩大治疗效果提供了新机会。人工智能(AI)进一步加速了新型肿瘤抗原的发现、优化了CAR设计,并实现了治疗反应的实时建模。将CAR-T疗法与人工智能驱动的平台、代谢重编程、双特异性抗体和先进的单细胞分析相结合,是增强肿瘤靶向性和反应持久性的有力策略。本综述总结了基于CAR-T疗法的新兴创新,探讨了它们与免疫疗法的协同应用,并讨论了与安全性、生产、成本和生物标志物验证相关的当前挑战。这些多学科努力共同为更有效和个性化的癌症治疗铺平了道路。