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Inicio Medicina Clínica (English Edition) Beyond CAR-T cells: Natural killer cells immunotherapy
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Vol. 154. Issue 4.
Pages 134-141 (February 2020)
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Vol. 154. Issue 4.
Pages 134-141 (February 2020)
Review
Beyond CAR-T cells: Natural killer cells immunotherapy
Más allá de las células CAR-T, inmunoterapia con linfocitos natural killer
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María Dolores Corral Sáncheza, Lucía Fernández Casanovab, Antonio Pérez-Martíneza,c,
Corresponding author
aperezmartinez@salud.madrid.org

Corresponding author.
a Servicio de Hemato-Oncología Pediátrica, Hospital Universitario La Paz, Madrid, Spain
b Centro Nacional de Investigaciones Oncológicas, Madrid, Spain
c Departamento de Pediatría, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
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Table 1. The most relevant clinical trials based on immunotherapy with NK cells, which show results.
Abstract

Children and adolescents suffering from refractory leukaemia, relapse after stem cell transplantation, solid metastatic tumour or refractory to conventional treatments still condition a dismal prognosis.

The critical role of the immune system in the immunosurveillance of cancer is becoming relevant with the development of new treatments such as the checkpoint inhibitor drugs and genetic modified T lymphocytes, tisagenlecleucel or axicabtagene ciloleucel. In addition, other immunotherapies are being developed such as cell therapy with Natural Killer (NK) lymphocytes. The rapid and potent cytotoxic activity of NK cells respecting healthy cells and the possibility of expansion, manipulating them and combining them with other treatments, make these cells a powerful therapeutic tool to be developed, with a very high safety profile. Furthermore, new strategies are being developed to increase the therapeutic benefit of NK cells such as genetic manipulation for the expression of chimeric antigen receptors.

Keywords:
Immunotherapy
Natural killer cells
KIR receptors
NKG2D
CAR-T cells
Resumen

A pesar de la mejoría en el pronóstico del cáncer infantil, la recaída o la refractariedad a los tratamientos convencionales todavía condicionan un mal pronóstico.

En el momento actual, la investigación en el área de la inmunoterapia, con medicamentos como los inhibidores de puntos críticos de control inmunitario y los linfocitos T modificados genéticamente, tisagenlecleucel o axicabtagene ciloleucel, están revolucionando el tratamiento del cáncer. En paralelo, se están desarrollando otras inmunoterapias como la terapia celular con linfocitos Natural Killer (NK).

La rápida y potente actividad citotóxica de las células NK respetando las células sanas y la posibilidad de expandirlas, manipularlas y combinarlas con otros tratamientos, hacen de estas células una poderosa herramienta terapéutica a desarrollar, con un perfil de seguridad muy alto. Además, se están desarrollando nuevas estrategias para incrementar el beneficio terapéutico de estas células como la manipulación genética para la expresión de receptores de antígeno quiméricos.

Palabras clave:
Inmunoterapia
Células natural killer
Receptores KIR
NKG2D
Células CAR-T

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