决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:A novel and efficient tandem CD19- and CD22-directed CAR for B cell ALL.
A novel and efficient tandem CD19- and CD22-directed CAR for B cell ALL.
靶向 CD19 的嵌合抗原受体(CAR)T 细胞在复发/难治性 B 细胞急性淋巴细胞白血病(B-ALL)中取得了令人印象深刻的缓解率;然而,多数患者最终因 CAR-T 细胞持久性差或耐药而复发。
靶向CD19的嵌合抗原受体(CAR)T细胞在难治或复发性B细胞急性淋巴细胞白血病(B-ALL)中取得了令人瞩目的缓解率;然而,由于CAR-T细胞持续存在能力差,或CD19+、CD19− B-ALL克隆产生耐药,大多数患者最终仍会复发。CD22是广泛表达于B细胞的标志物,在CD19+和CD19−复发中均持续表达。临床上已在B-ALL患者中使用CD22-CAR-T细胞,但仍会复发。采用单一构建体同时含CD19和CD22单链可变片段(scFv)的串联CAR(Tan-CAR)工程化T细胞,可能有助于提高缓解率和/或防止抗原丢失。我们利用前沿检测方法生成并进行了功能验证,构建了一种基于4-1BB、采用自主开发新型CD19和CD22 scFv的CD22/CD19 Tan-CAR。表达Tan-CAR的T细胞体外扩增与CD19-CAR-T细胞相近,且未增加基础性信号传导。经CRISPR-Cas9编辑的B-ALL细胞证实Tan-CAR具有双特异性。使用B-ALL细胞系、患者样本和患者来源异种移植模型(PDX)时,Tan-CAR体外和体内疗效均不逊于CD19-CAR。值得注意的是,在长期随访的PDX模型中,Tan-CAR强效抗白血病活性对疾病的控制略好。该Tan-CAR构建体值得开展临床评估,以检验同时靶向CD19和CD22能否增强白血病清除并降低或延迟复发率及抗原丢失。
CD19-directed chimeric antigen receptor (CAR) T cells have yielded impressive response rates in refractory/relapse B cell acute lymphoblastic leukemia (B-ALL); however, most patients ultimately relapse due to poor CAR T cell persistence or resistance of either CD19 + or CD19 - B-ALL clones. CD22 is a pan-B marker whose expression is maintained in both CD19 + and CD19 - relapses. CD22-CAR T cells have been clinically used in B-ALL patients, although relapse also occurs. T cells engineered with a tandem CAR (Tan-CAR) containing in a single construct both CD19 and CD22 scFvs may be advantageous in achieving higher remission rates and/or preventing antigen loss. We have generated and functionally validated using cutting-edge assays a 4-1BB-based CD22/CD19 Tan-CAR using in-house-developed novel CD19 and CD22 scFvs. Tan-CAR-expressing T cells showed similar in vitro expansion to CD19-CAR T cells with no increase in tonic signaling. CRISPR-Cas9-edited B-ALL cells confirmed the bispecificity of the Tan-CAR. Tan-CAR was as efficient as CD19-CAR in vitro and in vivo using B-ALL cell lines, patient samples, and patient-derived xenografts (PDXs). Strikingly, the robust antileukemic activity of the Tan-CAR was slightly more effective in controlling the disease in long-term follow-up PDX models. This Tan-CAR construct warrants a clinical appraisal to test whether simultaneous targeting of CD19 and CD22 enhances leukemia eradication and reduces/delays relapse rates and antigen loss.
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