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第43卷第5期             刘思远,陈 琳,夏安亮,等. 嵌合抗原受体NK细胞治疗肝细胞癌的研究进展[J].
                  2023年5月                    南京医科大学学报(自然科学版),2023,43(5):595-603,647                     ·601 ·


                久的反应性,且未见严重不良反应。                                 [6] EL⁃KHOUEIRY A B,SANGRO B,YAU T,et al. Nivolum⁃
                    综上,将抗 NKG2A 的免疫检查点抑制剂和                             ab in patients with advanced hepatocellular carcinoma
                CAR⁃NK 细胞联合治疗 HCC,既可以精准、快速、高                          (CheckMate 040):an open ⁃ label,non ⁃ comparative,
                                                                       phase 1/2 dose escalation and expansion trial[J]. Lancet,
                效地靶向肿瘤,又可以克服 HLA⁃E 介导的肿瘤对
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                NK细胞的抵抗,提高CAR⁃NK的功能。目前这一思
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                路正得到越来越多的关注,作为第一代抗癌免疫疗
                                                                       in patients with advanced hepatocellular carcinoma previ⁃
                法的补充,有望在将来HCC的基础研究和临床治疗
                                                                       ously treated with sorafenib(KEYNOTE⁃224):a non⁃ran⁃
                中展现进一步效果。                                              domised,open ⁃ label phase 2 trial[J]. Lancet Oncol,
                5  小结与展望                                               2018,19(7):940-952
                                                                 [8] SOVE R J,VERMA B K,WANG H,et al. Virtual clinical
                    CAR⁃NK细胞疗法凭借其出色的安全性和确切                             trials of anti⁃PD⁃1 and anti⁃CTLA⁃4 immunotherapy in ad⁃
                的疗效成为了肝癌免疫治疗领域的一颗新星,近年                                 vanced hepatocellular carcinoma using a quantitative sys⁃
                来针对不同靶点的CAR⁃NK细胞的临床前研究都显                               tems pharmacology model[J]. J Immunother Cancer,
                示出了良好的抗肿瘤效果,与 ICI 的联合应用也体                              2022,10(11):e005414
                                                                 [9] SCHULZ T U,ZIEROLD S,SACHSE M M,et al. Persis⁃
                现出了强大的抗癌活性。但无法回避的是,若想实
                                                                       tent immune ⁃ related adverse events after cessation of
                现肝癌的可靠治愈,CAR⁃NK 还需克服诸多挑战。
                                                                       checkpoint inhibitor therapy:prevalence and impact on
                未来CAR⁃NK 需要持续优化CAR的设计,以期获得                             patients’health⁃related quality of life[J]. Eur J Cancer,
                更好的特异性、更强的细胞毒性和更高的安全性。
                                                                       2022,176:88-99
                此外,如何逆转不断变化的肿瘤微环境对 NK 细胞                         [10] ELSALLAB M,LEVINE B L,WAYNE A S,et al. CAR T⁃
                的抑制,恢复NK细胞的功能以增强CAR⁃NK的抗癌                              cell product performance in haematological malignancies
                效果更是任重而道远的课题。欣喜的是,目前有很                                 before and after marketing authorisation[J]. Lancet On⁃
                多 CAR⁃NK 的基础研究和临床试验正在积极推进,                             col,2020,21(2):e104-e116
                而随着这些难题被不断突破,相信将来 CAR⁃NK 会                       [11] YOSHIDA Y,YOSHIO S,YAMAZOE T,et al. Phenotyp⁃
                                                                       ic characterization by single ⁃ cell mass cytometry of hu⁃
                在肝癌的免疫治疗中获得更广阔的应用前景。
                                                                       man intrahepatic and peripheral NK cells in patients with
               [参考文献]                                                  hepatocellular carcinoma[J]. Cells,2021,10(6):1495

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