白玥, 钟晓松, 李文斌. 嵌合抗原受体T细胞治疗多形性胶质母细胞瘤的最新进展[J]. 中国肿瘤临床, 2017, 44(16): 794-799. DOI: 10.3969/j.issn.1000-8179.2017.16.462
引用本文: 白玥, 钟晓松, 李文斌. 嵌合抗原受体T细胞治疗多形性胶质母细胞瘤的最新进展[J]. 中国肿瘤临床, 2017, 44(16): 794-799. DOI: 10.3969/j.issn.1000-8179.2017.16.462
BAI Yue, ZHONG Xiaosong, LI Wenbin. Progress on glioblastoma multiforme treatment with chimeric antigen receptor T-cells[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2017, 44(16): 794-799. DOI: 10.3969/j.issn.1000-8179.2017.16.462
Citation: BAI Yue, ZHONG Xiaosong, LI Wenbin. Progress on glioblastoma multiforme treatment with chimeric antigen receptor T-cells[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2017, 44(16): 794-799. DOI: 10.3969/j.issn.1000-8179.2017.16.462

嵌合抗原受体T细胞治疗多形性胶质母细胞瘤的最新进展

Progress on glioblastoma multiforme treatment with chimeric antigen receptor T-cells

  • 摘要: 多形性胶质母细胞瘤(glioblastoma multiforme,GBM)是恶性程度最高的脑胶质瘤,传统手术结合放、化疗疗效有限。嵌合抗原受体是由单一分子组成的抗原重组受体,重新定向T细胞的特异性和功能,由CD28或4-1BB构成的第二代CAR-T能识别抗原,完全活化T细胞并增强T细胞功能和持久性,是新兴GBM疗法的关注焦点。本文从CAR-T研究现状出发,主要介绍其发展历程和GBM相关的有效靶点,综述其理论基础,着重以白介素13受体α2、表皮生长因子受体变异Ⅶ、人表皮生长因子受体2和酪氨酸蛋白激酶受体A2这四种胶质瘤相关抗原为例,探讨靶点的结构、功能特性、前期研究和临床研究前景。选择性表达在GBM的白介素13受体α2在临床Ⅰ期治疗复发性GBM是安全有效的;表皮生长因子受体变异Ⅷ只存在于癌细胞和胶质母细胞瘤干细胞,与预后不良密切相关,正在进行Ⅰ、Ⅱ期临床试验;表皮生长因子受体2和酪氨酸蛋白激酶受体A也取得重大进展。这些特异性CAR-T可能成为治疗相应靶向阳性的GBM的重要免疫疗法。本文集中总结了目前CAR-T治疗GBM的应用价值及挑战。

     

    Abstract: Glioblastoma multiforme (GBM) is the most malignant form of glioma, and its treatment through traditional surgery combined with chemotherapy and radiotherapy has limited efficacy. Chimeric antigen receptor T-cells (CAR-T) are recombinant receptors for antigen, which, in a single molecule, redirect and mediate antigen recognition, T-cell activation, and, in the case of second-generation chimeric antigen receptors (CARs) costimulation (CD28 or 4-BB), augment T-cell functionality and persistence. CARs are the focus of attention in emerging treatment options for GBM. This article mainly introduces the development process of CAR-T therapy and the recent success of adoptive transfer of CAR-T cells. Effective targets of the treatment of GBM with CAR-T according to this research are discussed as well. Some of the most extensively studied targets on GBM, especially interleukin-13 receptor α chain variant 2, epidermal growth factor receptor-Ⅷ(EGFRⅧ), human epidermal growth factor receptor 2 (ErbB2), and ephrinA2 receptor (ErbA2), and the different characteristics of each kind of alloantigen-specific CAR-T cells, are the basis for CAR-T therapy and indicate their different characteristics or utilities and the prospect of further clinical research. The discovery of selective expression of interleukin-13 receptor alpha 2 in glioma cells more than 20 years ago prompted the clinical trial of CAR-T therapy in stage Ⅰ GBM tumors, and the therapy was proven safe and effective. EGFRⅧ is a neoantigen presenting only in cancer cells and glioblastoma stem cells. Its presence is correlated with poor prognosis, and a phase Ⅰ/Ⅱ trial is ongoing at different institutes. ErbB2-specific CARs were also expressed in human Tcells. Adoptive transfer of EphA2 (or ErbB2)-specific T cells resulted in the regression of glioma xenografts. Thus, target-specific CAR-T immunotherapy may be a promising approach for the treatment of different target-positive GBM. Finally, we summarize the application value and challenge of CAR-T cell therapy in the treatment of GBM.

     

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