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:Comparing CAR and TCR engineered T cell performance as a function of tumor cell exposure.
嵌合抗原受体(CAR)T 细胞疗法在治疗 CD19 阳性血液系统恶性肿瘤中带来了深远的临床反应,但相当一部分患者无反应或最终复发。
靶向CD19阳性血液系统恶性肿瘤的嵌合抗原受体(CAR)T细胞疗法已产生深度临床应答,但相当一部分患者无应答或最终复发。作为CAR T细胞的替代方案,也可通过工程化改造T细胞使其表达靶向肿瘤的T细胞受体(TCR)。尽管TCR受人类白细胞抗原(HLA)限制,靶向细胞表面抗原时CAR仍更受青睐;而工程化TCR(eTCR)T细胞与CAR T细胞的功能差异尚未得到充分界定。本研究以抗原暴露程度为变量,比较CAR T细胞与工程化TCR T细胞靶向B细胞恶性肿瘤相关抗原CD20的活性。结果显示,短时间内CAR T细胞效应更强,可产生更高水平细胞因子,杀伤效率也高于eTCR T细胞。然而,抗原暴露增加会显著损害CAR T细胞扩增,并导致共抑制分子高表达和效应分化。相较之下,在高抗原压力下,eTCR T细胞扩增优于CAR T细胞,共抑制分子表达较低,且能维持早期分化表型,同时仍可达到相近的肿瘤细胞清除效果。
Chimeric antigen receptor (CAR) T cell therapies have resulted in profound clinical responses in the treatment of CD19-positive hematological malignancies, but a significant proportion of patients do not respond or relapse eventually. As an alternative to CAR T cells, T cells can be engineered to express a tumor-targeting T cell receptor (TCR). Due to HLA restriction of TCRs, CARs have emerged as a preferred treatment moiety when targeting surface antigens, despite the fact that functional differences between engineered TCR (eTCR) T and CAR T cells remain ill-defined. Here, we compared the activity of CAR T cells versus engineered TCR T cells in targeting the B cell malignancy-associated antigen CD20 as a function of antigen exposure. We found CAR T cells to be more potent effector cells, producing higher levels of cytokines and killing more efficiently than eTCR T cells in a short time frame. However, we revealed that the increase of antigen exposure significantly impaired CAR T cell expansion, a phenotype defined by high expression of coinhibitory molecules and effector differentiation. In contrast, eTCR T cells expanded better than CAR T cells under high antigenic pressure, with lower expression of coinhibitory molecules and maintenance of an early differentiation phenotype, and comparable clearance of tumor cells.
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