RESUMEN
Resumen Una de las herramientas más novedosas en inmunoterapias adoptivas contra leucemias y tumores malignos es el uso del receptor de antígeno quimérico "CAR". El receptor CAR ha sido ampliamente utilizada en células T (células CAR-T) potenciando su eficacia en el reconocimiento y eliminación de tumores, obteniéndose a la fecha terapias basadas en esta tecnología. No obstante, las células CAR-T llegan a repercutir negativamente en la salud del paciente, presentando el síndrome neurológico de efecto inmune asociado a células (ICANS) y el síndrome de lanzamiento de citocinas (SLC). Como consecuencia, el paciente necesita ser hospitalizado durante la terapia. Además, el coste de manufactura y terapia es elevado, siendo una tecnología limitada a un sector muy bajo de la población. En este trabajo, mencionamos el empleo de una terapia emergente de células asesinas naturales (NK) con el receptor CAR (CAR-NK), que cuentan con muchas ventajas por encima de las células CAR-T. Las células CAR-NK conservan su capacidad citotóxica en contra de tumores gracias a su acción dependiente de receptores activadores e inhibidores, por lo que el receptor CAR, solo estimula sus habilidades y persistencia. Sumado a esto, el coste de una terapia de células CAR-NK podría resultar redituable debido a la capacidad de las células CAR-NK de eliminar múltiples células tumorales sin generar daño colateral en el paciente. Aquí analizamos las características de los múltiples receptores CAR y los fenotipos de células NK que han sido utilizados durante múltiples ensayos (NK-92, células NK de sangre cordal y periférica, y células NK iPSC).
Abstract One of the novel and effective devices against leukemia and solid tumors in adoptive immunotherapies is the use of the chimeric antigen receptor "CAR". CAR technology has been widely used in T-cells (CAR-T cells) empowering its efficacy on the identification and elimination of tumor cells, getting today certain drugs based on this technology. Nevertheless, CAR-T cells can have a negative impact on patient health, causing in many cases immune effector cell-associated neurotoxicity syndrome (ICANS) and cytokine release syndrome (CRS). As a consequence, the patient will have to be hospitalized for the duration of therapy. Moreover, the cost of manufacture and therapy is quite expensive, limiting its use to a low range of people. On the other hand, we analyze the advantages of Natural Killer cells with the CAR receptor (CAR-NK), which have many plusses over CAR-T cells. CAR-NK cells retain their cytotoxic abilities against tumor cells due their activator/ inhibitor receptors balance. Thus, the CAR receptor technology just increases their skills and persistence. Furthermore, CAR-NK therapy could be more profitable since CAR-NK can eliminate multiple tumor cells without generating collateral damage on patient health. Here, we discuss the characteristics of the multiples CAR receptors in general and the NK types cells that have been used in trials demonstrating their viable emerging therapy (NK-92, cord and peripheral blood NK cells, and iPSC-derived NK cells).
Asunto(s)
Humanos , Leucemia , Terapéutica , Inmunoterapia Adoptiva , Síndrome de Liberación de CitoquinasRESUMEN
Current advances of immunotherapy have greatly changed the way of cancer treatment. At the same time, a great number of nanoparticle-based cancer immunotherapies (NBCIs) have also been explored to elicit potent immune responses against tumors. However, few NBCIs are nearly in the clinical trial which is mainly ascribed to a lack understanding of
RESUMEN
Drug resistance,tumor relapse and metastasis remain the main obstacles to the success of cancer treatments. Chemotherapies,targeted therapies and immunotherapies can successfully achieve remissions in cancer patients,but durable responses are rare. Although the mechanisms of diverse therapies vary,plasticity alteration of tumor and immune cells in response to therapy-induced tumor tissue injury and inflammation contributes to the development of drug resistance. This review summarizes research progress in the adaptive phenotypic plasticity of tumor cells and immune cells during tumor progression as well as the successful combination of targeted therapy and immunotherapy in cancer treatment to tackle resistance.
RESUMEN
Drug resistance,tumor relapse and metastasis remain the main obstacles to the success of cancer treatments. Chemotherapies,targeted therapies and immunotherapies can successfully achieve remissions in cancer patients, but durable responses are rare. Although the mechanisms of diverse therapies vary,plasticity alteration of tumor and immune cells in response to therapy-induced tumor tissue injury and inflammation contributes to the development of drug resistance. This review summarizes research progress in the adaptive phenotypic plasticity of tumor cells and immune cells during tumor progression as well as the successful combination of targeted therapy and immunotherapy in cancer treatment to tackle resistance.