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:Preclinical Development and Evaluation of Allogeneic CAR T Cells Targeting CD70 for the Treatment of Renal Cell Carcinoma.
这些疗效和安全性数据支持对CD70 CAR T细胞治疗RCC的评估,并已推动一个异体CD70 CAR T细胞候选药物进入I期临床试验。
CD70在肾细胞癌(RCC)中高表达,而在正常组织中表达有限,使其成为具有免疫原性实体瘤适应症中一个有吸引力的CAR T靶点。在此,我们生成并表征了一组基于抗CD70单链可变区片段(scFv)的CAR T细胞。尽管CD70在T细胞上表达,但从一部分具有强效体外活性的scFv中成功制备了CAR T细胞。CD70 CAR的表达以顺式方式掩盖了CD70的检测,并提供了对CD70 CAR T细胞介导的同源杀伤的保护。鉴定出两类不同的CAR T细胞,其记忆表型、激活状态和细胞毒性活性各不相同。表位定位显示这两类CAR结合CD70的独特区域。CD70 CAR T细胞对RCC细胞系和患者来源异种移植小鼠模型显示出强大的抗肿瘤活性。组织交叉反应研究鉴定出淋巴细胞中的膜染色,从而与CD70的已知表达模式相符。在一项食蟹猴CD3-CD70双特异性毒性研究中,观察到了与T细胞激活和CD70表达细胞消除相关的预期发现,包括细胞因子释放和淋巴组织中细胞结构的丧失。最后,通过基于TALEN的基因编辑消除T细胞受体,大规模制备了高度功能性的CD70同种异体CAR T细胞。综上所述,这些疗效和安全性数据支持对CD70 CAR T细胞治疗RCC的评估,并已推动一个同种异体CD70 CAR T细胞候选药物进入I期临床试验。意义:这些发现证明了靶向肾细胞癌的抗自相残杀、同种异体抗CD70 CAR T细胞的疗效和安全性,以及CAR表位对功能活性的影响。参见Adot vi和Galaine的相关评论,第2517页。
UNLABELLED: CD70 is highly expressed in renal cell carcinoma (RCC), with limited expression in normal tissue, making it an attractive CAR T target for an immunogenic solid tumor indication. Here we generated and characterized a panel of anti-CD70 single-chain fragment variable (scFv)-based CAR T cells. Despite the expression of CD70 on T cells, production of CAR T cells from a subset of scFvs with potent in vitro activity was achieved. Expression of CD70 CARs masked CD70 detection in cis and provided protection from CD70 CAR T cell-mediated fratricide. Two distinct classes of CAR T cells were identified with differing memory phenotype, activation status, and cytotoxic activity. Epitope mapping revealed that the two classes of CARs bind unique regions of CD70. CD70 CAR T cells displayed robust antitumor activity against RCC cell lines and patient-derived xenograft mouse models. Tissue cross-reactivity studies identified membrane staining in lymphocytes, thus matching the known expression pattern of CD70. In a cynomolgus monkey CD3-CD70 bispecific toxicity study, expected findings related to T-cell activation and elimination of CD70-expressing cells were observed, including cytokine release and loss of cellularity in lymphoid tissues. Finally, highly functional CD70 allogeneic CAR T cells were produced at large scale through elimination of the T-cell receptor by TALEN-based gene editing. Taken together, these efficacy and safety data support the evaluation of CD70 CAR T cells for the treatment of RCC and has led to the advancement of an allogeneic CD70 CAR T-cell candidate into phase I clinical trials. SIGNIFICANCE: These findings demonstrate the efficacy and safety of fratricide-resistant, allogeneic anti-CD70 CAR T cells targeting renal cell carcinoma and the impact of CAR epitope on functional activity. See related commentary by Adot vi and Galaine, p. 2517.
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