单细胞追踪揭示黑色素瘤 TIL 治疗过程中肿瘤反应性 T 细胞的可塑性
Single-cell tracking reveals tumor-reactive T cell plasticity during melanoma TIL therapy.
TIL(肿瘤浸润淋巴细胞)过继细胞治疗可在转移性黑色素瘤中诱导持久缓解,然而在体外扩增过程中及回输后,调控肿瘤反应性T细胞命运的克隆和转录动态仍知之甚少。
英文原题:Phase I study of adjuvant immunotherapy with autologous tumor-infiltrating lymphocytes in locally advanced cervical cancer.
IL-2 注射。结果27 例患者中有 20 例的 TIL 成功扩增,可行性为 74.1%。
背景 采用TIL(肿瘤浸润淋巴细胞)(TILs)的过继细胞治疗(ACT)在转移性癌症如黑色素瘤和宫颈癌(CC)中已取得显著的临床疗效。在此,我们探索了在局部晚期CC患者中,同步放化疗(CCRT)后输注自体TILs(auto-TILs)辅助免疫治疗的安全性、可行性、初步肿瘤反应,并进行了转化研究。 方法 本单中心、I期研究招募了27例III-IV期CC患者。TILs从子宫颈病灶中分离,在良好生产规范(GMP)条件下扩增,然后在CCRT加肌内注射IL-2后输注。 结果 27例患者中有20例的TILs成功扩增,可行性为74.1%。12例患者在CCRT后接受了TILs治疗。不良事件(AEs)主要归因于CCRT。仅1例(8.3%)患者在TIL输注后出现严重毒性,表现为3级超敏反应。未发生自身免疫性AEs,如肺炎、肝炎或心肌炎,且无治疗相关死亡。12例患者中有9例(75.0%)达到完全缓解,疾病控制持续时间为9-22个月。转化研究表明,输注的TIL产品的转录组特征以及CC患者基线下肿瘤微环境和血清中的一些免疫生物标志物与临床反应相关。 结论 在学术中心环境下,CCRT后基于TIL的ACT是安全的,在局部晚期CC患者中具有潜在有效的反应。“热”炎性免疫环境有利于TIL为基础的ACT作为辅助治疗的临床疗效。试验注册ClinicalTrials.gov NCT04443296。资助国家重点项目研发计划;广州市科技基金会科技重点项目;广东省科技国际重点项目;国家自然科学基金。
BACKGROUNDAdoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TILs) has achieved remarkable clinical efficacy in metastatic cancers such as melanoma and cervical cancer (CC). Here, we explored the safety, feasibility, and preliminary tumor response and performed translational investigations of adjuvant immunotherapy using infusion of autogenous TILs (auto-TILs) following concurrent chemoradiotherapy (CCRT) in patients with CC who had locally advanced disease.METHODSTwenty-seven patients with CC with stage III-IV disease were recruited in this single-center, phase I study. TILs were isolated from lesions in the uterine cervix and generated under good manufacturing practice (GMP) conditions and then infused after CCRT plus i.m. IL-2 injections.RESULTSTILs from 20 of the 27 patients were successfully expanded, with a feasibility of 74.1%. Twelve patients received TILs following CCRT. Adverse events (AEs) were primarily attributable to CCRT. Only 1 (8.3%) patient experienced severe toxicity with a grade 3 hypersensitivity reaction after TIL infusion. No autoimmune AEs, such as pneumonitis, hepatitis, or myocarditis, occurred, and there were no treatment-related mortalities. Nine of 12 patients (75.0%) attained a complete response, with a disease control duration of 9-22 months. Translational investigation showed that the transcriptomic characteristics of the infused TIL products and some immune biomarkers in the tumor microenvironment and serum of patients with CC at baseline were correlated with the clinical response.CONCLUSIONTIL-based ACT following CCRT was safe in an academic center setting, with potentially effective responses in patients with locally advanced CC. "Hot" inflammatory immune environments were beneficial to the clinical efficacy of TIL-based ACT as adjuvant therapy.TRIAL REGISTRATIONClinicalTrials.gov NCT04443296.FUNDINGNational Key R&D Program; Sci-Tech Key Program of the Guangzhou City Science Foundation; the Guangdong Province Sci-Tech International Key Program; the National Natural Science Foundation of China.
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