Chimeric antigen receptor T cell (CAR-T) therapy has achieved remarkable results in hematological malignancies, but it still faces many challenges in the treatment of solid tumors. This article focuses on the impact of tumor microenvironment (TME) on the efficacy of CAR-T therapy, and deeply explores key issues such as antigen recognition barriers, antigen escape, cytokine storm, and immune checkpoint molecules. Through a review of the latest research results, this article proposes a variety of possible coping strategies, including reshaping TME, engineering CAR-T cells, regulating immune responses using the microbiome, and the auxiliary application of nanotechnology. In addition, the article compares the differences in the immune microenvironment between solid tumors and hematological tumors, reveals the main reason for the poor efficacy of CAR-T in solid tumors, and looks forward to the development prospects of this therapy in the treatment of solid tumors. This article aims to provide theoretical support and practical direction for optimizing CAR-T therapy and promote its application in the clinical treatment of solid tumors.
Rongxin Su (Fri,) studied this question.