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外周实体瘤的嵌合抗原受体T细胞(CAR-T)疗法与肿瘤重建手术——一项叙述性综述

CAR-T cell therapy and reconstructive oncologic surgery in peripheral solid tumors-A narrative review.

作者信息

Knoedler Leonard, Herfeld Konstantin, Schaefer Daniel A, Diatta Fortunay, Clune James, Evans Brogan, Seu Michelle, Kim Bong-Sung, Alfertshofer Michael, Schaschinger Thomas, Iske Jasper, Knoedler Samuel, Lellouch Alexandre G, Jeljeli Maxime, Carturan Alberto, Ruella Marco, Heiland Max, Poeck Hendrik, Perl Markus, Pomahac Bohdan, Kauke-Navarro Martin

机构信息

Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, USA; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Berlin, Germany; Division of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany.

出版信息

Cell Rep Med. 2025 Aug 19;6(8):102240. doi: 10.1016/j.xcrm.2025.102240. Epub 2025 Jul 16.

Abstract

This review addresses the integration of chimeric antigen receptor (CAR)-T cell therapy with reconstructive oncologic surgery in treating peripheral solid tumors, including melanoma, sarcomas, breast cancer, and head and neck cancers. While CAR-T cells have demonstrated effectiveness in blood cancers, their efficacy in solid tumors has been limited due to tumor heterogeneity, immune suppression, and poor cellular infiltration. Emerging approaches involving localized CAR-T cell delivery, improved CAR design, and targeted antigen selection (such as HER2, MUC1, GD2, and B7-H3) are discussed as promising strategies to enhance therapeutic outcomes. Clinical studies highlighted in this review indicate improved local tumor control and potential to optimize surgical resections. Additionally, combining CAR-T therapy with surgery may reduce tumor recurrence and positively influence reconstructive outcomes. Overall, this review underscores CAR-T cell therapy as a potential adjunctive treatment in oncologic surgery, emphasizing the importance of interdisciplinary approaches to improve patient outcomes in solid tumor management.

摘要

本综述探讨了嵌合抗原受体(CAR)-T细胞疗法与肿瘤重建手术在治疗外周实体瘤(包括黑色素瘤、肉瘤、乳腺癌和头颈癌)中的整合。虽然CAR-T细胞在血液癌症中已显示出有效性,但由于肿瘤异质性、免疫抑制和细胞浸润不良,它们在实体瘤中的疗效有限。本文讨论了涉及局部CAR-T细胞递送、改进的CAR设计和靶向抗原选择(如HER2、MUC1、GD2和B7-H3)的新兴方法,这些方法是增强治疗效果的有前景的策略。本综述中强调的临床研究表明,局部肿瘤控制得到改善,并且有优化手术切除的潜力。此外,将CAR-T疗法与手术相结合可能会降低肿瘤复发率,并对重建效果产生积极影响。总体而言,本综述强调CAR-T细胞疗法作为肿瘤手术中一种潜在辅助治疗的作用,强调跨学科方法对于改善实体瘤治疗中患者预后的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cee/12432357/4f28a78afb16/fx1.jpg

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