Yinqi Li

Camptothecin (CPT) and its derivatives are potent anticancer agents, but their clinical application is limited by poor aqueous solubility, lack of targeting specificity, and severe systemic toxicity. In this study, we synthesized a glycoconjugate prodrug, (GalNAc)₃-CPT, by conjugating CPT to a triantennary N-acetylgalactosamine (GalNAc) ligand that targeted the asialoglycoprotein receptor (ASGR) overexpressed on hepatocytes. This prodrug exhibited a solubility 2289 times higher than that of CPT in phosphate-buffered saline (pH 7.4). In vitro studies indicated that (GalNAc)₃-CPT was effectively taken up by hepatocellular carcinoma (HCC) cells, significantly reducing cell viability and inducing apoptosis. In vivo, (GalNAc)₃-CPT showed enhanced tumor targeting and superior antitumor activity compared to CPT and exhibited no detectable systemic toxicity. Moreover, it activated the cGAS-STING pathway and promoted the infiltration of CD8⁺ T cells into the tumor. In summary, GalNAc-mediated CPT delivery represents a promising strategy for targeted HCC therapy.

Adoptive cell therapy has revolutionized cancer treatment, especially for hematologic malignancies. T cells are the most extensively utilized cells in adoptive cell therapy. Currently, tumor-infiltrating lymphocytes, T cell receptor-transgenic T cells and chimeric antigen receptor T cells are the three main adoptive T cell therapies. Tumor-infiltrating lymphocytes kill tumors by reinfusing enlarged lymphocytes that naturally target tumor-specific antigens into the patient. T cell receptor-transgenic T cells have the ability to specifically destroy tumor cells via the precise recognition of exogenous T cell receptors with major histocompatibility complex. Chimeric antigen receptor T cells transfer genes with specific antigen recognition structural domains and T cell activation signals into T cells, allowing T cells to attack tumors without the assistance of major histocompatibility complex. Many barriers have been demonstrated to affect the clinical efficacy of adoptive T cell therapy, such as tumor heterogeneity and antigen loss, hard trafficking and infiltration, immunosuppressive tumor microenvironment and T cell exhaustion. Several strategies to improve the efficacy of adoptive T cell therapy have been explored, including multispecific chimeric antigen receptor T cell therapy, combination with immune checkpoint blockade, targeting the immunosuppressive tumor microenvironment, etc. In this review, we will summarize the current status and clinical application, followed by major bottlenecks in adoptive T cell therapy. In addition, we will discuss the promising strategies to improve adoptive T cell therapy. Adoptive T cell therapy will result in even more incredible advancements in solid tumors if the aforementioned problems can be handled. Graphical abstract