CAR-T exploration road focuses on the exploration and practice of CAR-T therapy by clinical scientists

Chimeric antigen receptor T (CAR-T) therapy, as a "new star" in the field of hematological tumor treatment, has attracted much attention since its birth
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In 2013, tumor immunotherapy represented by CAR-T was rated as the top ten scientific and technological breakthroughs of the year by the American "Science" magazine
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What is the "magic medicine" of CAR-T therapy? Can new breakthroughs be achieved in the future? How can biological therapy benefit more patients? In this article, the editor will bring you closer to CAR-T therapy and the exploration and practice of the biological therapy department of the Chinese People's Liberation Army General Hospital
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Tumor patients sought medical treatment, but fortunately met CAR-T therapy, and survived at the end of 2021, the biological treatment department of the Chinese People's Liberation Army General Hospital admitted a 68-year-old diffuse large B-cell lymphoma (DLBCL) patient
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Having received 5 times of chemotherapy, he has to face the cruel fact that his body function is weakened, and the treatment options are exhausted, and he seems to have no cure
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Just in time, the birth of CAR-T therapy has brought a glimmer of hope to patients with relapsed and refractory DLBCL
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One month after receiving CAR-T treatment, the efficacy evaluation showed a complete remission (CR), and the patient was discharged from the hospital successfully, which can be described as "survival in a desperate situation"
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CAR-T therapy emerges as the times require, with unique mechanism and strong efficacy In the clinical treatment of hematological tumors, relapsed/refractory hematological tumors have always been a very difficult problem
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Some patients still cannot be effectively controlled after receiving multi-line treatment, and the latter-line treatment plan is "stretched"
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In recent years, significant progress has been made in basic research and clinical diagnosis and treatment in the field of hematological tumors, and immunotherapy has increasingly shown clinical advantages
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As a new type of immunotherapy, CAR-T cells are called "Living drugs" with a unique mechanism of action
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By genetically modifying T cells to express chimeric antigen receptors that can recognize tumor cell antigens, T cells have completed the transformation from "general immune troops" to "special forces", namely CAR-T cells
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After CAR-T cells are expanded and infused back into the patient, they can recognize tumors more quickly and efficiently, leading to tumor cell apoptosis
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The advantage of CAR-T cells lies in their strong "killing power", which can help patients achieve deep remission and reduce the recurrence rate
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The road to CAR-T research and development is long.
Hematological tumors have been successful, and solid tumors are still being explored.
The Department of Biotherapy of the Chinese People's Liberation Army General Hospital has been conducting in-depth research on CAR-T therapy since its establishment, from cell culture to sequence screening.
"Customization", gradually breaking through from single target to dual target, overcoming difficulties and obstacles, and finally obtained the molecular structure of CAR targeting CD19 and CD20, and carried out clinical translational research in May 2017
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The results of the study published in Leukemia showed that the overall response rate was approximately 78%, and the median progression-free survival (PFS) was 27.
6 months, showing the outstanding advantages of potency and long-term efficacy¹
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At present, CAR-T therapy has achieved initial results in the field of hematological tumors, but the developers keep moving forward, and continue to open up new paths in the field of solid tumors in order to benefit more tumor patients
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The application of CAR-T therapy in solid tumors faces many challenges: lack of specific antigens, CAR-T cell transport and tumor infiltration, immunosuppression of the tumor microenvironment,
etc.

With the deepening of research and the breakthrough of technical barriers, CAR-T therapy is expected to be applied to solid tumors in the future, benefiting more patients
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The Exploration and Development of the Biotherapy Department of the Chinese People's Liberation Army General Hospital The Chinese People's Liberation Army General Hospital established the Biotherapy Department in April 2012, which is the first established translational medicine department for tumor biotherapy research in China.
of advanced cancer patients
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At the beginning of the establishment of the department, it has closely integrated basic research and clinical practice, which not only promotes the transformation of research results, but also benefits patients
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For example, in the treatment of Hodgkin lymphoma, the combination of decitabine on the basis of programmed death receptor 1 (PD-1) monoclonal antibody monotherapy significantly improved the CR rate of patients
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At present, the DP regimen (decitabine + PD-1 monoclonal antibody) has been approved by the CSCO guidelines and is widely used in clinical practice
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In addition to the DP program, the Biotherapeutics Department has also been fruitful in exploring other combination programs, saving the lives of many patients
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In recent years, biotherapy has entered a new stage of rapid development.
Behind every innovation and breakthrough in medical technology, there is a group of people who never forget their original aspirations and act with determination.
They are clinical scientists who promote the progress of medical science and civilization
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Under the leadership of academic leaders, the Department of Biological Therapy of the Chinese People's Liberation Army General Hospital has been constantly looking for breakthrough treatment plans for patients and exploring cutting-edge issues in the field of oncology with a positive attitude
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Going back and forth, the road is long and long, but they choose to go upstream and forge ahead! Summary The birth of CAR-T therapy has ignited new hope for patients with hematological tumors, but CAR-T therapy does not stop there.
Although the exploration in solid tumors is difficult, it is expected to meet the needs of clinical scientists through the continuous efforts of clinical scientists.
Come the dawn of victory
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The field of biological therapy is developing rapidly.
The Chinese People's Liberation Army General Hospital has always been striving at the forefront, and actively applying the results of basic research to clinical practice, saving the lives of many patients and benefiting thousands of families
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Reference: [1] Zhang Y, Wang Y, Liu Y, et al.
Long-term activity of tandem CD19/CD20 CAR therapy in refractory/relapsed B-cell lymphoma: a single-arm, phase 1-2 trial.
Leukemia .
2022 Jan;36(1):189-196.
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