ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2025, Vol. 34 ›› Issue (3): 274-278.DOI: 10.3969 / j.issn.1006⁃298X.2025.03.015

• 肾脏病临床 • 上一篇    下一篇

嵌合抗原受体 T 细胞治疗血液肿瘤的耐药机制及应对策略

  

  • 出版日期:2025-06-28 发布日期:2025-06-26

Resistance  mechanisms  to  chimeric  antigen  receptor  T  cell  therapy  and  overcoming  strategies  in  hematologic malignancies

  • Online:2025-06-28 Published:2025-06-26

摘要: 嵌合抗原受体( CAR) T 细胞疗法在血液系统恶性肿瘤的治疗中取得了革命性进展,尤其是急性淋巴细胞白血病、弥漫性大 B 细胞淋巴瘤、滤泡性淋巴瘤和多发性骨髓瘤等。 然而,大多数患者最终会对该疗法产生耐药,CAR⁃T 细胞疗法主要的耐药机制包括CAR⁃T  细胞功能障碍、抗原逃逸以及免疫抑制性的肿瘤微环境,克服耐药机制的策略包括改善体内 T 细胞功能、优化 CAR⁃T 细胞产品、调节免疫抑制的肿瘤微环境等。

关键词: 嵌合抗原受体 T 细胞, 血液肿瘤, 耐药机制 , 抗原逃逸, 肿瘤微环境

Abstract: Chimeric antigen  receptor  ( CAR) T  cell  therapy  has  made  revolutionary  progress  in  the  treatment  of hematologic malignancies, particularly  showing  promising  efficacy  in  patients  with  acute  lymphoblastic  leukemia,  diffuse large B⁃cell lymphoma, follicular lymphoma, and multiple myeloma. However, most patients eventually develop resistance to this therapy. The main mechanisms of resistance to CAR⁃T cell therapy include CAR⁃T cell dysfunction, antigen escape, and the immunosuppressive tumor microenvironment. Strategies to overcome these resistance mechanisms include improving T cell function in vivo, optimizing CAR⁃T cell products, and modulating the immunosuppressive tumor microenvironment.

Key words: chimeric  antigen , receptor , T , cell, hematologic  malignancies ,  , resistance, antigen  escape,  ,  ,  tumor microenvironment