Nature系列综述：in vivo CAR-T细胞疗法

Core Insights - The article discusses the transformative potential of in vivo CAR-T cell therapy, which aims to overcome the limitations of traditional CAR-T therapies by generating CAR-T cells directly within the patient, thus eliminating complex manufacturing and logistics challenges [2][3][6]. Group 1: In Vivo CAR-T Technology - In vivo CAR-T technology leverages advancements in virology, RNA therapeutics, and nanomedicine to deliver genetic material encoding CAR into endogenous T cells, enhancing clinical efficacy and simplifying the treatment process [2][3][9]. - The technology aims to expand the applicability of CAR-T therapies beyond hematological malignancies to include autoimmune diseases like systemic lupus erythematosus [3][7]. Group 2: Clinical Development and Platforms - The article highlights two main in vivo CAR platforms: engineered viral vectors (such as lentiviruses) that integrate payloads into the host genome, and lipid nanoparticles (LNPs) that enable transient expression of the payload within host cells [9][11]. - Several companies are developing in vivo CAR-T therapies, with various targeting mechanisms and therapeutic payloads aimed at treating conditions like B cell malignancies and solid tumors [10][11]. Group 3: Future Directions and Challenges - The review emphasizes the need for innovation in delivery and engineering technologies to fully realize the potential of CAR-T therapies, addressing current limitations in accessibility and clinical performance [7][15]. - The transition from ex vivo to in vivo CAR-T therapies is expected to redefine the scalability and accessibility of immunotherapies, significantly reducing production costs and enhancing the socio-economic impact of these life-saving treatments [23].