来那度胺增强慢性淋巴细胞白血病中的 CD23.CAR-T 细胞治疗

Chimeric antigen receptors (CAR)-modified T cells are an emerging therapeutic tool for chronic lymphocytic leukemia (CLL).

However, in patients with CLL, well-known T-cell defects and the inhibitory properties of the tumor microenvironment (TME) hinder the efficacy of CAR T cells.

We explored a novel approach combining CARs with lenalidomide, an immunomodulatory drug that tempers the immunosuppressive activity of the CLL TME. T cells from patients with CLL were engineered to express a CAR specific for CD23, a promising target antigen. Lenalidomide maintained the in vitro effector functions of CD23. CAR + T cells effector functions in terms of antigen-specific cytotoxicity, cytokine release and proliferation.

Overall, lenalidomide preserved functional CAR T-CLL cell immune synapses. In a Rag2 -/- c -/- -based xenograft model of CLL, we demonstrated that, when combined with low-dose lenalidomide, CD23. CAR + T cells efficiently migrated to leukemic sites and delayed disease progression when compared to CD23. CAR + T cells given with rhIL-2. These observations underline the therapeutic potential of this novel CAR-based combination strategy in CLL.