Chimeric antigen receptor-T cells have spearheaded the field of adoptive cell therapy and have shown remarkable results in treating hematological neoplasia. Because of the different biology of solid tumors compared to hematological tumors, response rates of CAR-T cells could not be transferred to solid entities yet. CAR engineering has added co-stimulatory domains, transgenic cytokines and switch receptors to improve performance and persistence in a hostile tumor microenvironment, but because of the inherent cell type limitations of CAR-T cells, including HLA incompatibility, toxicities (cytokine release syndrome, neurotoxicity) and high costs due to the logistically challenging preparation process for autologous cells, the use of alternative immune cells is gaining traction. NK cells and γδ T cells that do not need HLA compatibility or macrophages and dendritic cells with additional properties such as phagocytosis or antigen presentation are increasingly seen as cellular vehicles with potential for application. As these cells possess distinct properties, clinicians and researchers need a thorough understanding of their peculiarities and commonalities. This review will compare these different cell types and their specific modes of action seen upon CAR activation.
嵌合抗原受体T细胞引领了过继性细胞治疗领域，并在治疗血液系统肿瘤方面展现出显著疗效。由于实体肿瘤与血液肿瘤在生物学特性上存在差异，CAR-T细胞在实体瘤中的应答率尚未达到同等水平。通过CAR工程化改造，已引入共刺激结构域、转基因细胞因子及开关受体以提升其在恶劣肿瘤微环境中的效能与持久性，但鉴于CAR-T细胞固有的细胞类型局限性——包括HLA不匹配、毒性反应（细胞因子释放综合征、神经毒性）以及自体细胞制备流程复杂导致的高昂成本——替代性免疫细胞的应用正日益受到关注。无需HLA匹配的NK细胞与γδ T细胞，以及具有吞噬或抗原呈递等附加功能的巨噬细胞与树突状细胞，正逐渐被视为具有应用潜力的细胞载体。由于这些细胞各具独特属性，临床医生与研究者需深入理解其特性与共性。本综述将系统比较这些不同细胞类型及其在CAR激活后的特异性作用模式。
The Spectrum of CAR Cellular Effectors: Modes of Action in Anti-Tumor Immunity
肿瘤(癌症)患者之家