对化学抗原受体T细胞疗法的抗性机制
Grace A Johnson1, Frederick L Locke2
1University of South Florida Morsani College of Medicine, 560 Channelside Drive, Tampa, FL 336022, USA.
Hematology/oncology clinics of North America
|August 14, 2023
概括
化学抗原受体 (CAR) T细胞疗法对血液癌症具有前景,但瘤耐药性限制了有效性. 了解和克服目标损失和T细胞枯竭等机制对于改善CAR T细胞治疗结果至关重要.
科学领域:
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
- 细胞疗法细胞疗法
背景情况:
- 化学抗原受体 (CAR) T细胞疗法已经彻底改变了耐火性血液恶性瘤的治疗方法.
- 对于诸如大B细胞淋巴瘤,多发性骨髓瘤和白血病等疾病,观察到响应率的显著改善.
- 尽管取得了成功,但由于瘤抵抗机制,在实现普遍疗效方面仍然存在挑战.
研究的目的:
- 审查和综合当前关于针对CAR T细胞治疗提出的瘤耐药性机制的数据.
- 确定影响CAR T细胞治疗反应的有效性和耐久性的关键因素.
- 突出未来研究领域,旨在提高CAR T细胞疗法的有效性.
主要方法:
- 对研究CAR T细胞治疗耐药性的综合文献综述.
- 分析了可能导致治疗失败的生物和环境因素.
- 综合了与T细胞耗尽,抗原损失和瘤微环境相关的数据.
- 检查CAR T细胞扩张和瘤对效应因子比率对结果的影响.
主要成果:
- 瘤对CAR T 细胞疗法的耐药性是多因素的,涉及目标损失和T 细胞耗尽.
- 低于最佳的CAR T细胞扩张和免疫抑制瘤微环境会对持久反应产生负面影响.
- 瘤对效应细胞的比率是治疗成功的关键决定因素.
结论:
- 克服已识别的抗药性机制对于最大限度地发挥CAR T细胞疗法的潜力至关重要.
- 未来的策略应该集中在缓解T细胞耗尽,防止目标损失和优化瘤微环境上.
- 增强CAR T细胞扩张和实现最佳的效应因子比率将增强这种突破性的疗法的疗效.
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