Yang Dorothy D, Macmorland William, Arnold James N
School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom.
Front Immunol. 2025 Sep 11;16:1643941. doi: 10.3389/fimmu.2025.1643941. eCollection 2025.
Chimeric antigen receptor (CAR) T-cell therapy is a transformative immunotherapeutic approach, yet its application in solid tumors is hindered by the immunosuppressive tumor microenvironment (TME). The TME restricts T-cell trafficking, impairs effector functions, and promotes exhaustion through soluble factors, metabolic stress, and suppressive cell populations. Recent efforts to enhance CAR T-cell efficacy have focused on armoring strategies that 'reprogram' and 'boost' T-cell responses within the TME. These include engineered expression of dominant-negative receptors or cytokine-releasing constructs (such as IL-12 and IL-18) to reshape the local immune milieu and improve T-cell effector function, synthetic Notch receptors for inducible gene expression, and chemokine receptor knock-ins to improve tumor infiltration. Additional approaches aim to modulate intrinsic metabolic pathways to improve CAR T-cell persistence under hypoxic or nutrient-deprived conditions. Armoring strategies that recruit bystander or endogenous immune cells also activate broader anti-tumor immunity that prevents antigen escape and may induce more durable anti-tumor responses. This review highlights the molecular and cellular mechanisms by which current armoring strategies enhance CAR T-cell functions in solid tumors, offering a perspective on improving immune cell engineering for overcoming the hurdles encountered in deploying these therapies against solid cancers.
嵌合抗原受体(CAR)T细胞疗法是一种变革性的免疫治疗方法,但其在实体瘤中的应用受到免疫抑制性肿瘤微环境(TME)的阻碍。TME限制T细胞运输,损害效应功能,并通过可溶性因子、代谢应激和抑制性细胞群体促进T细胞耗竭。最近提高CAR T细胞疗效的努力集中在“强化”策略上,即在TME内“重新编程”和“增强”T细胞反应。这些策略包括工程表达显性负性受体或细胞因子释放构建体(如IL-12和IL-18)以重塑局部免疫环境并改善T细胞效应功能、用于诱导基因表达的合成Notch受体以及敲入趋化因子受体以改善肿瘤浸润。其他方法旨在调节内在代谢途径,以改善CAR T细胞在缺氧或营养缺乏条件下的持久性。招募旁观者或内源性免疫细胞的强化策略还可激活更广泛的抗肿瘤免疫,防止抗原逃逸,并可能诱导更持久的抗肿瘤反应。本综述重点介绍了当前强化策略增强实体瘤中CAR T细胞功能的分子和细胞机制,为改进免疫细胞工程提供了一个视角,以克服在将这些疗法应用于实体癌时遇到的障碍。