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:Targeting of the alpha(v) beta(3) integrin complex by CAR-T cells leads to rapid regression of diffuse intrinsic pontine glioma and glioblastoma.
这些结果突显了v 3 CAR-T细胞在侵袭性脑肿瘤免疫治疗中的潜力,由于v 3在正常组织中表达受限,其靶向、脱靶介导的毒性风险降低。
弥漫性内生性桥脑胶质瘤(DIPG)和胶质母细胞瘤(GBM)是两种高度侵袭性且通常无法治愈的胶质瘤,过去几十年在治疗方面进展甚微。尽管嵌合抗原受体(CAR)T细胞在治疗白血病和淋巴瘤方面取得了巨大的初步成功,但将CAR-T细胞应用于包括胶质瘤在内的实体瘤仍待取得重大进展。整合素复合物αvβ3(αvβ3)存在于多种不同的实体瘤类型和肿瘤血管系统中,而在大多数正常组织中表达有限,使其成为CAR-T细胞介导免疫治疗的一个有吸引力的靶点。
患者来源的DIPG和GBM细胞系通过流式细胞术评估了v 3的表面表达。表达抗v 3单链可变片段的第二代CAR-T细胞通过逆转录病毒转导生成,包含CD28或4-1BB共刺激结构域和CD3zeta。CAR-T细胞通过流式细胞术评估了CAR表达、记忆表型分布和抑制性受体谱。DIPG和GBM细胞系通过立体定向注射原位植入NSG小鼠,并通过生物发光成像监测,以评估v 3 CAR-T细胞介导的抗肿瘤反应。
我们发现,患者来源的DIPG细胞和GBM细胞系通过流式细胞术检测高表达表面v 3,而通过RNA测序和蛋白质微阵列检测,v 3在正常组织中表达极低。制备的CAR-T细胞包含大量有利的早期记忆细胞和低抑制性受体谱。v 3 CAR-T细胞在细胞毒性试验和体内模型中均表现出高效、抗原特异性的肿瘤细胞杀伤,这些模型是将DIPG和GBM肿瘤原位和立体定向植入NSG小鼠大脑的相关位置。肿瘤反应迅速且强烈,伴有系统性CAR-T细胞增殖和与长期生存相关的持久性。肿瘤清除后,可检测到TCF-1 + v 3 CAR-T细胞,突显了它们持久存在和进行自我更新的能力。
BACKGROUND: Diffuse intrinsic pontine glioma (DIPG) and glioblastoma (GBM) are two highly aggressive and generally incurable gliomas with little therapeutic advancements made in the past several decades. Despite immense initial success of chimeric antigen receptor (CAR) T cells for the treatment of leukemia and lymphoma, significant headway into the application of CAR-T cells against solid tumors, including gliomas, is still forthcoming. The integrin complex alpha v beta 3 ( v 3 ) is present on multiple and diverse solid tumor types and tumor vasculature with limited expression throughout most normal tissues, qualifying it as an appealing target for CAR-T cell-mediated immunotherapy. METHODS: Patient-derived DIPG and GBM cell lines were evaluated by flow cytometry for surface expression of v 3 . Second-generation CAR-T cells expressing an anti- v 3 single-chain variable fragment were generated by retroviral transduction containing either a CD28 or 4-1BB costimulatory domain and CD3zeta. CAR-T cells were evaluated by flow cytometry for CAR expression, memory phenotype distribution, and inhibitory receptor profile. DIPG and GBM cell lines were orthotopically implanted into NSG mice via stereotactic injection and monitored with bioluminescent imaging to evaluate v 3 CAR-T cell-mediated antitumor responses. RESULTS: We found that patient-derived DIPG cells and GBM cell lines express high levels of surface v 3 by flow cytometry, while v 3 is minimally expressed on normal tissues by RNA sequencing and protein microarray. The manufactured CAR-T cells consisted of a substantial frequency of favorable early memory cells and a low inhibitory receptor profile. v 3 CAR-T cells demonstrated efficient, antigen-specific tumor cell killing in both cytotoxicity assays and in in vivo models of orthotopically and stereotactically implanted DIPG and GBM tumors into relevant locations in the brain of NSG mice. Tumor responses were rapid and robust with systemic CAR-T cell proliferation and long-lived persistence associated with long-term survival. Following tumor clearance, TCF-1 + v 3 CAR-T cells were detectable, underscoring their ability to persist and undergo self-renewal. CONCLUSIONS: These results highlight the potential of v 3 CAR-T cells for immunotherapeutic treatment of aggressive brain tumors with reduced risk of on-target, off-tumor mediated toxicity due to the restricted nature of v 3 expression in normal tissues.
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