为肝细胞癌武装 GPC3 CAR-T 细胞:多少才足够,下一步是什么?
Armouring GPC3 CAR T cells for hepatocellular carcinoma: how much is enough and what comes next?
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Immunotherapy of HBV-related advanced hepatocellular carcinoma with short-term HBV-specific TCR expressed T cells: results of dose escalation, phase I trial.
Immunotherapy of HBV-related advanced hepatocellular carcinoma with short-term HBV-specific TCR expressed T cells: results of dose escalation, phase I trial.
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将 HBV-TCR-T 细胞过继转移至晚期 HBV-HCC 患者总体安全且耐受性良好。临床疗效观察支持该治疗策略在晚期 HBV 相关 HCC 患者中的持续开发和最终应用。临床试验注册:本研究已在 ClinicalTrials.gov 注册(NCT03899415)。
HBV相关肝细胞癌(HBV-HCC)患者肝移植后接受HBV特异性TCR重定向T(HBV-TCR-T)细胞免疫治疗被报道是安全的,并具有潜在的治疗效果。我们旨在探讨HBV-TCR-T细胞免疫治疗在未达到肝移植标准的晚期HBV-HCC患者中的安全性。
我们入组了8例晚期HBV-HCC患者,并过继转移表达HBV特异性TCR的短寿命自体T细胞,开展一项开放标签、1期剂量递增研究(NCT03899415)。主要终点是根据美国国家癌症研究所常见不良事件评价标准(4.03版)在剂量递增过程中评估HBV-TCR-T细胞疗法的安全性。次要终点是通过使用RECIST标准(1.1版)评估抗肿瘤反应以及总生存期,来评估HBV-TCR-T细胞疗法的疗效。
在入组的8例患者中,有2例观察到不良事件。仅1例患者在接受了1×10^5 HBV-TCR-T细胞/kg的剂量后出现了3级肝脏相关不良事件,随后未经免疫抑制剂干预即恢复正常。在患者中,有1例获得了持续27.7个月的部分缓解。重要的是,大多数患者在HBV-TCR-T细胞输注后表现出循环HBsAg和HBV DNA水平的降低或稳定,表明其靶向效应。
We enrolled eight patients with advanced HBV-HCC and adoptively transferred short-lived autologous T cells expressing HBV-specific TCR to perform an open-label, phase 1 dose-escalation study (NCT03899415). The primary endpoint was to evaluate the safety of HBV-TCR-T-cell therapy according to National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.03) during the dose-escalation process. The secondary endpoint was to assess the efficacy of HBV-TCR-T-cell therapy by evaluating the anti-tumor responses using RECIST criteria (version 1.1) and the overall survival.
Adverse events were observed in two participants among the 8 patients enrolled. Only one patient experienced a Grade 3 liver-related adverse event after receiving a dose of 1 10 5 HBV-TCR-T cells/kg, then normalized without interventions with immunosuppressive agents. Among the patients, one achieved a partial response lasting for 27.7 months. Importantly, most of the patients exhibited a reduction or stabilization of circulating HBsAg and HBV DNA levels after HBV-TCR-T-cell infusion, indicating the on-target effects.
The adoptive transfer of HBV-TCR-T cells into advanced HBV-HCC patients were generally safe and well-tolerated. Observations of clinical efficacy support the continued development and eventual application of this treatment strategy in patients with advanced HBV-related HCC. CLINICAL TRIALS REGISTRATION: This study was registered at ClinicalTrials.gov (NCT03899415).
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