［摘要］嵌合型抗原受体修饰T（chimeric antigen receptor modified T，CAR-T）细胞疗法在血液恶性肿瘤患者（尤其是CD19 阳性患者）中取得了较好的临床效果，被认为是近几年肿瘤治疗的重大进步，引起了研究者对开发CAR-T细胞治疗肿瘤的强烈兴趣。但是CAR-T细胞肿瘤治疗过程中也存在一些问题，如部分患者由于需要等待较长的CAR-T细胞培养时间，从而失去治疗机会；CAR-T细胞治疗过程中一些特有的不良反应甚至危及患者生命，CAR-T细胞治疗对实体瘤的疗效不尽人意，即使是对血液恶性肿瘤来说部分患者也终究会复发导致治疗失败；因此探索提高CAR-T细胞疗效的方法、及时发现CAR-T细胞治疗的不良反应并给予适当处理、扩大CAR-T细胞治疗的可能获益人群是目前CAR-T细胞治疗研究需要解决的问题。本文对目前CAR-T细胞治疗存在的一些问题进行归纳，包括通用型CAR-T细胞的前景、双靶点CAR-T细胞和CAR-T细胞在血液肿瘤治疗中的地位及作用、提高CAR-T细胞治疗疗效的策略以及CAR-T细胞特有的不良反应等进行阐述，为CAR-T细胞肿瘤治疗的基础研究和临床应用提供借鉴。

[Abstract] Chimeric antigen receptor modified T (CAR-T) cell therapy has achieved excellent clinical efficacy in patients with hematological malignancies (especially for patients with CD19 positive), and is regarded as a major advance in cancer therapy in recent years.It aroused scientists’strong interest in developing CAR-T cell products for the treatment of cancers. However, there are still some problems in the treatment of CAR-T cells. For examples, some patients lose the opportunity of CAR-T cell therapy while waiting for CAR-T cell culture, some unique adverse events during treatment of CAR-T cell therapy may endanger the patients’life, and the efficacy of CAR-T cell therapy is unsatisfactory on solid tumors. Even for hematological malignancies, some patients will eventually relapse and lead to treatment failure. Therefore, exploring methods to improve the efficacy, diagnosis the unique adverse events of CAR-T cell therapy early and give appropriately management, expand potentially benefiting populations of CAR-T cell therapy are issues that need to be addressed in current CAR-T cell therapy research.

河南省医学科技攻关计划项目（No.201701030）