嵌合抗原受体T细胞治疗实体瘤的再思考

Reconsidering CAR-T cell therapy for solid tumors

嵌合抗原受体T细胞(CAR-T)治疗恶性血液肿瘤已取得令人瞩目的疗效,但治疗实体瘤尚存在疗效不佳和可能出现的特殊毒性风险等问题。文中分析了CAR-T细胞治疗实体瘤疗效不佳的原因,包括肿瘤异质性、CAR-T细胞难以归巢、免疫抑制微环境、脱靶效应、T细胞衰竭等,并提出了提高CAR-T细胞治疗实体瘤疗效的相应策略和未来的发展趋势。

Chimeric antigen receptor T cells(CAR-T)have achieved remarkable therapeutic effects in the treatment of malignant hematological tumors,but there are still some problems including poor efficacy and possible toxicity risks in the treatment of solid tumors.This paper analyzes the reasons for the poor efficacy of CAR-T cells in the treatment of solid tumors,including tumor heterogeneity,difficulty in homing of CAR-T cells,immunosuppressive microenvironment,off-target effect,T cell exhaustion and so on,and proposes the strategies and future trends in improving the efficacy of CAR-T in the treatment of solid tumors.