Progress in clinical studies of chimeric antigen receptor engineered T cells for treatment of childhood cancer.
- Author:
Ya-Ru NI
1
;
Xiao-Jun XU
;
Yong-Min TANG
Author Information
1. Department of Hematology-Oncology, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China. medico-xxj@163.com.
- Publication Type:Journal Article
- MeSH:
Antigens, CD19;
immunology;
Child;
Humans;
Immunotherapy, Adoptive;
adverse effects;
methods;
Neoplasms;
therapy;
Receptors, Antigen, T-Cell;
genetics;
T-Lymphocytes;
transplantation
- From:
Chinese Journal of Contemporary Pediatrics
2017;19(11):1219-1224
- CountryChina
- Language:Chinese
-
Abstract:
Nowadays, the 5-year survival rate of childhood cancer patients can be more than 80%, but some patients with relapse and refractory cancers have shown no good response to traditional strategies. Chimeric antigen receptor engineered T (CAR-T) cell therapy is promising for these patients. CAR-T cells recognize the tumor-associated antigens in a non-major histocompatibility complex-restricted manner, so their anti-tumor ability is enhanced. There are four generations of CAR-T cells now. The complete remission rate of pediatric patients with relapse and refractory acute lymphoblastic leukemia can be as high as 90% when treated with CD19-targeting CAR-T cells. Furthermore, CAR-T cell therapy can also be used to bridge to transplantation and donor CAR-T cell infusion can be a strategy to prevent relapse after hematopoietic stem cell transplantation. As to solid tumors, only patients with neuroblastoma present good response to the GD2-targeting CAR-T cell therapy. The toxic or side effects of CAR-T cell therapy include cytokine release syndrome, off-tumor effect, tumor lysis syndrome, and insertion mutation. Although the CD19-targeting CAR-T cell therapy for childhood cancer can result in a high remission rate, the relapse rate is high, including CD19and CD19relapse. The mechanisms for relapse merit further investigatio.
