嵌合抗原受体T细胞免疫疗法在肝癌中的应用进展  

Application Progress of Chimeric Antigen Receptor T-Cell Immunotherapy in Liver Cancer

作　　者：徐晶晶 胡滨[1] 娄月芬 XU Jingjing;HU Bin;LOU Yuefen(Department of Pharmacy,Shanghai Fourth People′s Hospital Affiliated to Tongji University,Shanghai 200434,China)

机构地区：[1]同济大学附属上海市第四人民医院药剂科,上海200434

出　　处：《医学综述》2023年第20期4074-4083,4089,共11页Medical Recapitulate

基　　金：上海市临床药学重点专科建设项目(区属)(沪卫药政〔2019〕1号);上海市第四人民医院学科助推计划(SY-XKZT-2021-1021)。

摘　　要：嵌合抗原受体T细胞(CAR-T细胞)疗法已在肝癌治疗中表现出极大潜力。多种肿瘤相关抗原被用于肝癌的CAR-T细胞疗法,包括claudin18.2、癌胚抗原、甲胎蛋白等。但CAR-T细胞疗法仍存在一定的局限性,如难以到达肿瘤部位、肿瘤外效应、肿瘤的免疫抑制微环境、肿瘤对CAR-T细胞疗法的耐药性、肿瘤相关抗原异质性及不良反应。研究者已使用多种策略来应对CAR-T细胞疗法的局限性,以提高其有效性和安全性。虽然CAR-T细胞疗法在肝癌领域已表现良好的临床获益,但仍存在耐药和安全性等问题,开发新的肿瘤相关抗原、确定输注剂量、用药途径、适用人群和联用方案是未来的研究方向。Chimeric antigen receptor T-cell(CAR-T cell)therapy has shown great potential in treating liver cancer.A variety of tumor-associated antigens have been used in CAR-T cell therapy for liver cancer,including claudin18.2,carcinoembryonic antigen,α-fetoprotein,etc.However,there are still limitations of CAR-T cell therapy in the treatment of solid tumors such as liver cancer,such as the difficulty of CAR-T cell to reach the tumor site,off-tumor effects,immunosuppressive microenvironment of tumors,tumor resistance to CAR-T cell therapy,heterogeneity of tumor-associated antigens,and adverse effects of CAR-T cell therapy.Researchers have used various strategies to address these limitations of CAR-T cell therapy to improve its efficacy and safety.Although CAR-T cell therapy has achieved remarkable clinical efficacy in the treatment of liver cancer,there are still issues with drug resistance and safety.Development of new tumor-associated antigens,determination of infusion doses,routes of administration,applicable populations and combination regimens are directions for the further research.

关 键 词：肝癌 嵌合抗原受体T细胞 免疫疗法 肿瘤相关抗原 

分 类 号：R735.7[医药卫生—肿瘤]