嵌合抗原受体(CAR)T细胞疗法已经改变了癌症免疫疗法。然而,重大挑战限制了其在B细胞驱动的恶性肿瘤之外的应用,包括有限的临床疗效,高毒性,和复杂的自体细胞产品制造。尽管努力改善CART细胞治疗结果,人们对利用替代免疫细胞来开发CAR细胞越来越感兴趣。这些免疫细胞提供了几个优点,如主要组织相容性复合体(MHC)独立功能,肿瘤微环境(TME)调制,和增加组织浸润能力。目前,来自各种T细胞亚型的CAR产品,先天免疫细胞,造血祖细胞,甚至外泌体也在探索中。这些CAR产品通常显示出增强的抗肿瘤功效,毒性降低,和优越的肿瘤渗透。考虑到这些好处,许多临床试验正在进行中,以获得这些创新的CAR细胞的潜力。这篇综述旨在彻底研究这些优势,挑战,以及对这些新的CAR产品在癌症治疗中的现有见解。
Chimeric antigen receptor (CAR) T cell therapy has transformed cancer immunotherapy. However, significant challenges limit its application beyond B cell-driven malignancies, including limited clinical efficacy, high toxicity, and complex autologous cell product manufacturing. Despite efforts to improve CAR T cell therapy outcomes, there is a growing interest in utilizing alternative immune cells to develop CAR cells. These immune cells offer several advantages, such as major histocompatibility complex (MHC)-independent function, tumor microenvironment (TME) modulation, and increased tissue infiltration capabilities. Currently, CAR products from various T cell subtypes, innate immune cells, hematopoietic progenitor cells, and even exosomes are being explored. These CAR products often show enhanced antitumor efficacy, diminished toxicity, and superior tumor penetration. With these benefits in mind, numerous clinical trials are underway to access the potential of these innovative CAR cells. This review aims to thoroughly examine the advantages, challenges, and existing insights on these new CAR products in cancer treatment.