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:T cells expressing CD5/CD7 bispecific chimeric antigen receptors with fully human heavy-chain-only domains mitigate tumor antigen escape.
双特异性CAR-T 细胞疗法在晚期B细胞恶性肿瘤的临床试验中显示出有希望的结果。
双特异性CAR-T 细胞疗法在晚期B细胞恶性肿瘤的临床试验中已显示出令人鼓舞的结果。然而,将双特异性CAR-T疗法的成功拓展至治疗难治/复发性(r/r)T细胞白血病/淋巴瘤具有挑战性,因为靶向多种T细胞表达抗原会导致CAR-T细胞自相残杀加剧及潜在的安全性担忧。研究筛选了特异性靶向CD5或CD7的全人源重链可变区(FHVH)抗体,并构建了CD5/CD7双特异性CAR。将截短型表皮生长因子受体整合入CAR构建体中,以解决安全性问题。为解决靶向T细胞泛标志物的CAR-T细胞自相残杀问题,在慢病毒转导双特异性CAR之前,进行了基于CRISPR/Cas9的CD5和CD7基因敲除。在体外和体内对不同双特异性CAR结构——串联CAR和双CAR——进行了功能比较,以确定最适合解决临床环境中T细胞恶性肿瘤抗原逃逸的最佳构建体。敲除CD5和CD7可防止CD5/CD7双特异性CAR-T细胞的自相残杀,且FHVH衍生的CD5/CD7双特异性CAR-T细胞在体外和体内均表现出强效抗肿瘤活性。抗自相残杀的FHVH衍生CD5/CD7双特异性CAR-T细胞对T细胞恶性肿瘤具有强效抗肿瘤活性,且串联CAR在防止异质性白血病细胞肿瘤逃逸方面比双CAR更有效。串联CD5/CD7 CAR-T细胞具有意义的临床疗效和安全性值得迫切探索。
Bispecific chimeric antigen receptor T-cell (CAR-T) therapies have shown promising results in clinical trials for advanced B-cell malignancies. However, it is challenging to broaden the success of bispecific CAR-T therapies to treat refractory/relapse (r/r) T-cell leukemia/lymphoma because targeting multiple T-cell-expressing antigens leads to exacerbated CAR-T cell fratricide and potential safety concerns. Fully human heavy chain variable (FHV H ) antibodies that specifically target CD5 or CD7 were screened and constructed to CD5/CD7 bispecific CARs. A truncated Epidermal growth factor receptor were integrated into CAR constructs to address safety concerns. To tackle the fratricidal issue of CAR-T cells targeting T-cell-pan marker(s), CRISPR/Cas9-based CD5 and CD7 genes knockout were performed before lentiviral transduction of bispecific CARs. Functional comparison between different bispecific CAR structures: tandem CARs and dual CAR were performed in vitro and in vivo to determine the optimal construct suitable for addressing T-cell malignancy antigen escape in clinical setting. Knockout of CD5 and CD7 prevents fratricide of CD5/CD7 bispecific CAR-T cells, and FHV H -derived CD5/CD7 bispecific CAR-T cells demonstrate potent antitumor activity in vitro and in vivo. The fratricide-resistant FHV H -derived CD5/CD7 bispecific CAR-T cells have potent antitumor activity against T-cell malignancies, and tandem CARs are more effective than dual CAR in preventing tumor escape in heterogeneous leukemic cells. The meaningful clinical efficacy and safety of tandem CD5/CD7 CAR-T cells deserve to be explored urgently.
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