Exploiting the curative potential of adoptive T-cell therapy for cancer.

Exploiting the curative potential of adoptive T-cell therapy for cancer.
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DOI:
10.1111/imr.12132
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发表时间:
2014-01
影响因子:
8.7
通讯作者:
Rosenberg SA
Rosenberg SA
中科院分区:
医学1区
文献类型:
--
作者:
Hinrichs CS;Rosenberg SA

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过继性t细胞转移(ACT)是一种有效而灵活的癌症治疗方式,可以诱导某些人类恶性肿瘤的完全、持久的消退。对接受肿瘤浸润淋巴细胞(til)治疗的转移性黑色素瘤患者的长期随访显示,有相当一部分患者经历了完全、持久的肿瘤消退,并且可能被治愈。越来越多的证据表明,突变基因产物是黑色素瘤TILs的主要免疫靶点。最近的技术进步允许快速鉴定由这些体细胞基因突变和对这些靶标具有反应性的T细胞产生的新表位。这些T细胞的分离和过继性转移可以改善TIL治疗黑色素瘤,并允许其更广泛地应用于非黑色素瘤肿瘤。通过抗原受体基因工程,ACT也可能扩展到其他恶性肿瘤。在b细胞恶性肿瘤中表达靶向CD19的嵌合抗原受体或在滑膜细胞肉瘤和黑色素瘤中表达靶向NY-ESO-1的T细胞受体后,观察到肿瘤消退。在此,我们回顾了最近的临床试验的til和抗原受体基因治疗晚期癌症。我们将讨论这一经验的教训,并考虑如何应用这些教训来实现联合疗法的全部治疗潜力。
Adoptive T-cell transfer (ACT) is a potent and flexible cancer treatment modality that can induce complete, durable regression of certain human malignancies. Long-term follow up of patients receiving tumor-infiltrating lymphocytes (TILs) for metastatic melanoma reveals a substantial subset that experienced complete, lasting tumor regression – and may be cured. Increasing evidence points to mutated gene products as the primary immunological targets of TILs from melanomas. Recent technological advances permit rapid identification of the neoepitopes resulting from these somatic gene mutations and of T cells with reactivity against these targets. Isolation and adoptive transfer of these T cells may improve TIL therapy for melanoma and permit its broader application to non-melanoma tumors. Extension of ACT to other malignancies may also be possible through antigen receptor gene engineering. Tumor regression has been observed following transfer of T cells engineered to express chimeric antigen receptors against CD19 in B-cell malignancies or a T-cell receptor against NY-ESO-1 in synovial cell sarcoma and melanoma. Herein we review recent clinical trials of TILs and antigen receptor gene therapy for advanced cancers. We discuss lessons from this experience and consider how they might be applied to realize the full curative potential of ACT.
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