Liu Yihao, Gao Yizhu, Huo Chenyu, Zeng Tao, Meng Wenjun, Zhang Haoling, He Qinqin
Department of Pain Management, West China Hospital, Sichuan University, Chengdu, China; Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, China.
Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China.
Transl Oncol. 2026 Feb;64:102662. doi: 10.1016/j.tranon.2025.102662. Epub 2026 Jan 6.
Lung cancer ranks first among all malignancies in incidence, with current treatment strategies including surgery, chemotherapy, immunotherapy, and targeted therapy. Despite these advances, drug resistance in advanced non-small cell lung cancer (NSCLC) remains a major obstacle and innovative therapeutic approaches are imperative to address it. Chimeric antigen receptor T-cell (CAR-T) therapy has shown impressive and long-lasting results in blood cancers, but its success in solid tumors such as lung cancer remains limited. This review summarizes recent advances and future directions of CAR-T therapy in NSCLC, focusing on major therapeutic targets such as EGFR, MSLN, PD-L1, MUC1, CEA, and ROR1, as well as on the efficacy and potential of combining CAR-T therapy with other treatment modalities. Additionally, we discuss adverse events in NSCLC patients undergoing CAR-T therapy, emphasizing cytokine release syndrome (CRS) and cardiovascular complications-their incidence, pathophysiology, interrelation, and management strategies.
肺癌的发病率在所有恶性肿瘤中位居首位，目前的治疗策略包括手术、化疗、免疫疗法和靶向疗法。尽管取得了这些进展，但晚期非小细胞肺癌（NSCLC）中的耐药性仍然是一个主要障碍，因此必须采用创新的治疗方法来解决这一问题。嵌合抗原受体T细胞（CAR-T）疗法在血液癌症中已显示出令人印象深刻且持久的效果，但其在肺癌等实体瘤中的成功仍然有限。本综述总结了CAR-T疗法在NSCLC中的最新进展和未来方向，重点关注主要治疗靶点，如表皮生长因子受体（EGFR）、间皮素（MSLN）、程序性死亡配体1（PD-L1）、粘蛋白1（MUC1）、癌胚抗原（CEA）和受体酪氨酸激酶样孤儿受体1（ROR1），以及CAR-T疗法与其他治疗方式联合使用的疗效和潜力。此外，我们还讨论了接受CAR-T疗法的NSCLC患者的不良事件，重点强调细胞因子释放综合征（CRS）和心血管并发症——它们的发病率、病理生理学、相互关系及管理策略。
