首页|期刊导航|中国肿瘤生物治疗杂志|靶向实体瘤CAR-T细胞设计:安全性与通用性提升策略

靶向实体瘤CAR-T细胞设计:安全性与通用性提升策略OA北大核心

Design of CAR-T cells targeting solid tumors:strategies for enhancing safety and universality

中文摘要英文摘要

嵌合抗原受体基因修饰T细胞(CAR-T细胞)疗法是一种肿瘤免疫治疗方法:来自人体的T细胞在体外经遗传学修饰、表达特异性嵌合抗原受体(CAR),然后将其回输入患者体内,用于靶向识别和消除肿瘤细胞.尽管CAR-T细胞疗法在血液系统肿瘤治疗中取得了较为显著的成功,其在实体瘤治疗中仍面临障碍.细胞因子释放综合征(CRS)等免疫相关不良反应(irAE)制约了CAR-T细胞的安全应用,肿瘤相关抗原(TAA)的异质性限制了单一CAR-T细胞的广谱适用性,也制约了其通用型开发.鉴于此,要使CAR-T细胞疗法在实体瘤临床治疗中得到应用,还需开展进一步的改良与提升研究.本文围绕实体瘤中CAR-T细胞疗法,从"CAR基因修饰策略"、"通用免疫受体的再靶向策略"及"抗原通用性'赋靶'策略"三个方面对CAR-T细胞领域中为提高安全性和通用性所进行的探索进行述评,系统剖析各策略的研究路径、优势及局限性,并展望未来发展方向.通过综述CAR-T细胞安全性和普适性设计策略的进展,本文旨在为实体瘤的CAR-T细胞疗法研发提供创新思路.

Chimeric antigen receptor gene-modified T(CAR-T)cell therapy represents an immunotherapeutic approach wherein autologous T cells are genetically engineered ex vivo to express specific chimeric antigen receptors(CARs),expanded,and reinfused into patients to specifically recognize and eliminate tumor cells.Despite substantial efficacy in hematological malignancies,CAR-T cell therapy encounters significant barriers in solid tumors.Immune-related adverse events(irAEs),including cytokine release syndrome(CRS),compromise safety profiles,while tumor-associated antigen(TAA)heterogeneity restricts both single-target CAR-T cell applicability and universal CAR-T cell development.Consequently,breakthrough refinements remain essential for clinical translation in solid tumors.This review examines CAR-T cell therapy for solid tumors,critically evaluating safety and universality enhancement strategies through three core approaches:structural CAR design optimization,universal immune receptor retargeting,and antigen universality augmentation.Each approach undergoes systematic analysis of research pathways,advantages,and limitations,with future trajectories delineated.By synthesizing advances in safety and universal design paradigms,the review aims to establish innovative frameworks for CAR-T cell therapeutic development in solid tumor therapeutics.

邱毓灵;廖天艺;刘宝瑞;李茹恬

南京大学医学院附属鼓楼医院 肿瘤中心,江苏 南京 210008南京大学医学院附属鼓楼医院 肿瘤中心,江苏 南京 210008南京大学医学院附属鼓楼医院 肿瘤中心,江苏 南京 210008南京大学医学院附属鼓楼医院 肿瘤中心,江苏 南京 210008

医药卫生

实体瘤免疫治疗嵌合抗原T细胞疗法脱靶效应开关CAR-T细胞

solid tumor immunotherapychimeric antigen receptor gene-modified T(CAR-T)cell therapyoff-target effectswitchable CAR-T cell

《中国肿瘤生物治疗杂志》 2025 (6)

559-569,11

国家自然科学基金(No.82272852)江苏省杰出青年基金(No.BK20240017)

10.3872/j.issn.1007-385x.2025.06.001

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