乳腺癌（BC）是中国第四大常见癌症。尽管采用传统的治疗策略，但 BC 患者的治疗效果往往不佳，导致全球癌症死亡率很高。基于嵌合抗原受体 (CAR) 的免疫疗法是一种有前景的创新癌症治疗方法，可重新引导免疫细胞攻击表达选定肿瘤抗原 (TA) 的肿瘤细胞。 T 细胞、自然杀伤 (NK) 细胞和巨噬细胞是免疫系统的关键组成部分，用于基于 CAR 的免疫疗法。尽管CAR-T细胞在血液恶性肿瘤中取得了显着进展，但基于CAR的免疫疗法在BC上的应用却滞后。这部分是由于肿瘤异质性等障碍造成的，肿瘤异质性进一步与 TA 和 BC 亚型以及免疫抑制性肿瘤微环境 (TME) 有关。已经提出了几种组合方法，包括使用免疫检查点抑制剂、溶瘤病毒和抗肿瘤药物来克服 BC 治疗中的这些障碍。此外，几种基于 CAR 的 BC 免疫疗法已转化为临床试验。本综述概述了基于 CAR 的 BC 免疫疗法的最新进展，包括 TA 的靶向、BC 亚型的考虑、TME 的评估以及组合疗法的探索。作者重点关注了特别是在中国进行的 CAR-T 细胞、CAR-NK 细胞和 CAR-巨噬细胞的临床前研究和临床试验，随后对当前限制进行了内部比较和讨论。总之，本综述阐明了中国对基于 CAR 的 BC 免疫疗法的贡献，并为进一步的研究提供了启发。通俗易懂的总结：尽管有传统的治疗策略，中国的乳腺癌（BC）患者往往治疗效果不佳。基于嵌合抗原受体（CAR）的免疫疗法是一种很有前景的方法，它可以重定向免疫细胞以杀死表达选定肿瘤抗原（TA）的肿瘤细胞。然而，TA选择、BC亚型、免疫抑制肿瘤微环境等障碍仍然存在。因此，提出了各种组合方法。本文阐述了国内几项基于CAR治疗BC的临床前和临床研究，并与国外研究进行比较，并对CAR免疫细胞进行了分析，为进一步的研究提供启发。© 2023 作者。 《癌症》由 Wiley periodicals LLC 代表美国癌症协会出版。

Breast cancer (BC) is the fourth most prevalent cancer in China. Despite conventional treatment strategies, BC patients often have poor therapeutic outcomes, leading to significant global cancer mortality rates. Chimeric antigen receptor (CAR)-based immunotherapy is a promising and innovative approach for cancer treatment that redirects immune cells to attack tumor cells expressing selected tumor antigens (TAs). T cells, natural killer (NK) cells, and macrophages, key components of the immune system, are used in CAR-based immunotherapies. Although remarkable progress has been made with CAR-T cells in hematologic malignancies, the application of CAR-based immunotherapy to BC has lagged. This is partly due to obstacles such as tumor heterogeneity, which is further associated with the TA and BC subtypes, and the immunosuppressive tumor microenvironment (TME). Several combinatorial approaches, including the use of immune checkpoint inhibitors, oncolytic viruses, and antitumor drugs, have been proposed to overcome these obstacles in BC treatment. Furthermore, several CAR-based immunotherapies for BC have been translated into clinical trials. This review provides an overview of the recent progress in CAR-based immunotherapy for BC treatment, including targeting of TAs, consideration of BC subtypes, assessment of the TME, and exploration of combinatorial therapies. The authors focused on preclinical studies and clinical trials of CAR-T cells, CAR-NK cells, and CAR-macrophages especially conducted in China, followed by an internal comparison and discussion of current limits. In conclusion, this review elucidates China's contribution to CAR-based immunotherapies for BC and provides inspiration for further research. PLAIN LANGUAGE SUMMARY: Despite conventional treatment strategies, breast cancer (BC) patients in China often have poor therapeutic outcomes. Chimeric antigen receptor (CAR)-based immunotherapy, a promising approach, can redirect immune cells to kill tumor cells expressing selected tumor antigens (TAs). However, obstacles such as TA selection, BC subtypes, and immunosuppressive tumor microenvironment still exist. Therefore, various combinatorial approaches have been proposed. This article elucidates several Chinese CAR-based preclinical and clinical studies in BC treatment with comparisons of foreign research, and CAR-immune cells are analyzed, providing inspiration for further research.© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.