论文标题

T细胞白血病的CAR T细胞:数学模型的见解

CAR T cells for T-cell leukemias: Insights from mathematical models

论文作者

Pérez-García, Víctor M., León-Triana, O., Rosa, M., Pérez-Martínez, A.

论文摘要

免疫疗法有可能改变所有癌症类型的治疗和治愈方式。癌症免疫疗法使用患者免疫系统的元素攻击肿瘤细胞。免疫疗法最成功的类型之一是CAR-T细胞。该治疗方法是提取患者的T细胞并增加抗原受体,允许识别和靶向肿瘤细胞。这些新细胞称为CAR-T细胞,并在体外扩张后将其重新注入患者。这种方法已成功用于治疗B细胞恶性肿瘤(B细胞白血病和淋巴瘤)。但是,其应用于T细胞白血病的治疗面临几个问题。其中之一是肾脏,因为CAR-T细胞靶向肿瘤和其他CAR-T细胞。这导致非线性动力学现象适合数学建模。在本文中,我们构建了一个数学模型,描述了CAR-T,肿瘤和正常T细胞的竞争,并研究了该模型的一些基本特性及其实际含义。具体而言,我们发现该模型再现了观察到的在实验室中发现的治疗细胞体外膨胀的困难。该数学模型预测,由于大量靶标的初始存在,患者的CAR-T细胞扩张将有可能。我们还表明,在我们的数学方法的背景下,CAR-T细胞可以控制肿瘤的生长,而不能消除该疾病。

Immunotherapy has the potential to change the way all cancer types are treated and cured. Cancer immunotherapies use elements of the patient immune system to attack tumor cells. One of the most successful types of immunotherapy is CAR-T cells. This treatment works by extracting patient's T-cells and adding to them an antigen receptor allowing tumor cells to be recognized and targeted. These new cells are called CAR-T cells and are re-infused back into the patient after expansion in-vitro. This approach has been successfully used to treat B-cell malignancies (B-cell leukemias and lymphomas). However, its application to the treatment of T-cell leukemias faces several problems. One of these is fratricide, since the CAR-T cells target both tumor and other CAR-T cells. This leads to nonlinear dynamical phenomena amenable to mathematical modeling. In this paper we construct a mathematical model describing the competition of CAR-T, tumor and normal T-cells and studied some basic properties of the model and its practical implications. Specifically, we found that the model reproduced the observed difficulties for in-vitro expansion of the therapeutic cells found in the laboratory. The mathematical model predicted that CAR-T cell expansion in the patient would be possible due to the initial presence of a large number of targets. We also show that, in the context of our mathematical approach, CAR-T cells could control tumor growth but not eradicate the disease.

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