Yan Lihui, Duan Boshi, Sun Peng, Wang Tianzuo, Wang Tianyou, Jiang Shuang, Wang Yue
Department of Pain Relief Therapeutic, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, Shenyang, China.
Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
Discov Oncol. 2025 Aug 22;16(1):1593. doi: 10.1007/s12672-025-03282-9.
Cancer immunotherapy has transformed oncology, with CAR-T cell therapy emerging as a cornerstone of personalized treatment for hematologic malignancies. In China, rapid advancements in domestically developed CAR-T therapies have achieved clinical outcomes comparable to global benchmarks, with overall response rates (ORR) of 79-89% in B-cell malignancies and 64% 12-month progression-free survival in multiple myeloma. Despite these successes, CAR-T application in solid tumors remains hindered by antigen heterogeneity, immunosuppressive microenvironments, and on-target/off-tumor toxicity. To address these barriers, China has pioneered innovative strategies, including dual-target CAR-T constructs, armored CAR-Ts secreting immunomodulatory cytokines, and synergistic integration with traditional Chinese medicine, which enhances CAR-T efficacy by inhibiting myeloid-derived suppressor cells and reducing cytokine release syndrome. Notably, preclinical studies demonstrate that Huangqin increases tumor regression rates from 40 to 65% in lung cancer models when combined with CAR-T therapy. Concurrently, China is reshaping accessibility through policy innovations such as the "1 + 3 + N" multi-tiered payment system and regional insurance pilots, which reduce patient costs by 50%. Strategic investments in automated manufacturing and global regulatory harmonization further position China as a leader in cost-effective CAR-T development. However, challenges persist in solid tumor targeting, international market integration, and long-term safety monitoring. Future directions emphasize precision engineering, AI-driven treatment optimization, and cross-border collaborations to advance next-generation therapies. By balancing innovation, affordability, and policy agility, China is poised to drive the global evolution of cancer immunotherapy while addressing unmet needs in both hematologic and solid malignancies.
癌症免疫疗法已经改变了肿瘤学领域，嵌合抗原受体T细胞（CAR-T）疗法成为血液系统恶性肿瘤个性化治疗的基石。在中国，国产CAR-T疗法的快速发展取得了与全球标准相当的临床疗效，B细胞恶性肿瘤的总缓解率（ORR）为79-89%，多发性骨髓瘤的12个月无进展生存率为64%。尽管取得了这些成功，但CAR-T在实体瘤中的应用仍然受到抗原异质性、免疫抑制微环境和靶向脱瘤毒性的阻碍。为了克服这些障碍，中国率先采用了创新策略，包括双靶点CAR-T构建体、分泌免疫调节细胞因子的武装CAR-T，以及与传统中药的协同整合，通过抑制髓源性抑制细胞和减少细胞因子释放综合征来提高CAR-T疗效。值得注意的是，临床前研究表明，黄芩与CAR-T疗法联合使用时，可使肺癌模型中的肿瘤消退率从40%提高到65%。与此同时，中国正在通过“1+3+N”多层次支付系统和区域保险试点等政策创新来重塑可及性，这些措施将患者成本降低了50%。在自动化制造和全球监管协调方面的战略投资进一步使中国成为具有成本效益的CAR-T开发的领导者。然而，在实体瘤靶向、国际市场整合和长期安全监测方面仍然存在挑战。未来的方向强调精准工程、人工智能驱动的治疗优化以及跨境合作，以推进下一代疗法。通过平衡创新、可负担性和政策灵活性，中国有望推动癌症免疫疗法的全球发展，同时满足血液系统和实体恶性肿瘤中未满足的需求。
