[摘要] 嵌合抗原受体T（chimeric antigen receptor T,CAR-T）细胞治疗近年来发展迅速，已在某些血液系统的恶性肿瘤治疗中取得了惊人的疗效，但在实体肿瘤的治疗中进展不大。目前在CAR-T细胞治疗中需要解决的问题主要有：（1）增强CAR-T细胞的杀伤活性；（2）解除肿瘤免疫抑制状态；（3）使CAR-T细胞进入实体瘤；（4）增强CAR-T细胞治疗的安全性。通过CAR结构的优化设计，可以克服CAR-T细胞治疗中的一系列缺陷，增强CAR-T细胞的疗效和减缓并发症的发生。本文对近年来在CAR结构设计上的一些优化改进措施及方法进行总结分析，探索提高CAR-T细胞治疗过程中有效性和安全性的策略和措施。

[Abstract] CAR-T cell therapy has developed rapidly in recent years, and has achieved amazing results in the treatment of some malignant tumors of the blood system, but little progress has been made in the treatment of solid tumors. At present, the main problems to be solved in CAR-T cell therapy are: (1) enhancing the killing activity of CAR-T cells; (2) relieving the immunosuppressive state of tumors;(3) bringing CAR-T cells into solid tumors; (4) enhancing the safety of CAR-T cell therapy. By optimizing the structure of CAR,a series of defects in the CAR-T cell therapy can be overcome, and the curative effect of CAR-T can be enhanced and the complications can be alleviated. In this paper, some optimization and improvement measures and methods on the structure design of CAR in recent years are elaborated, and the effectiveness and safety of the CAR-T cell therapy are explored.

国家自然科学基金资助项目（No.31171427）；首都临床特色应用研究基金（No.Z121107001012136）