抗 CD22/CD19 CAR-T 细胞疗法 CART2219.1 在成人和儿童复发/难治性 B-ALL 中的 I/II 期试验
A Phase I/II Trial of Anti-CD22/CD19 CAR-T Cell Therapy, CART2219.1, in Adult and Pediatric Relapsed/Refractory B-ALL.
在一项多中心I/II期试验中,所有患者(n=11;7名儿童,4名成人)在第28天均达到完全缓解(91%为微小残留病阴性)。
英文原题:WT1-specific TCRs directed against newly identified peptides install antitumor reactivity against acute myeloid leukemia and ovarian carcinoma.
我们的方法获得了一组天然表达的WT1肽和四个TCR,它们是在WT1表达肿瘤患者中,包括AML和卵巢癌,进行TCR基因转移策略的有前景的候选者。
转录因子Wilms瘤基因1(WT1)因其在多种肿瘤中表达、在正常组织中低水平表达以及在癌症进展中的促进作用,是一种理想的肿瘤靶点。在临床试验中,WT1通过基于肽或树突状细胞的疫苗以及基于T细胞受体(TCR)的疗法进行靶向。已有抗肿瘤反应性的报道,但T细胞反应性受到对WT1的自身耐受以及WT1肽数量有限的阻碍,迄今为止这些肽是基于HLA肽结合算法筛选的。
在本研究中,我们通过在同种异体健康供体的T细胞库中寻找高亲和力的WT1特异性T细胞,克服了这两个限制,这些T细胞特异性针对源自原发性白血病和卵巢癌样本HLA I类相关配体组的WT1肽段。
使用广泛的恶性细胞和健康细胞亚群面板,筛选出对八个新鉴定的WT1肽段中的五个表现出强效且特异性抗WT1 T细胞反应性的T细胞克隆。值得注意的是,先前用于临床试验的WT1肽段的T细胞克隆对肿瘤细胞缺乏反应性,表明这些肽段的加工和呈递有限。分析了四个T细胞克隆的TCR序列,将TCR基因转移至CD8+ T细胞后,赋予了对表达WT1的实体瘤细胞系、原发性急性髓系白血病(AML)母细胞和卵巢癌患者样本的抗肿瘤反应性。
BACKGROUND: Transcription factor Wilms' tumor gene 1 (WT1) is an ideal tumor target based on its expression in a wide range of tumors, low-level expression in normal tissues and promoting role in cancer progression. In clinical trials, WT1 is targeted using peptide-based or dendritic cell-based vaccines and T-cell receptor (TCR)-based therapies. Antitumor reactivities were reported, but T-cell reactivity is hampered by self-tolerance to WT1 and limited number of WT1 peptides, which were thus far selected based on HLA peptide binding algorithms. METHODS: In this study, we have overcome both limitations by searching in the allogeneic T-cell repertoire of healthy donors for high-avidity WT1-specific T cells, specific for WT1 peptides derived from the HLA class I associated ligandome of primary leukemia and ovarian carcinoma samples. RESULTS: Using broad panels of malignant cells and healthy cell subsets, T-cell clones were selected that demonstrated potent and specific anti-WT1 T-cell reactivity against five of the eight newly identified WT1 peptides. Notably, T-cell clones for WT1 peptides previously used in clinical trials lacked reactivity against tumor cells, suggesting limited processing and presentation of these peptides. The TCR sequences of four T-cell clones were analyzed and TCR gene transfer into CD8+ T cells installed antitumor reactivity against WT1-expressing solid tumor cell lines, primary acute myeloid leukemia (AML) blasts, and ovarian carcinoma patient samples. CONCLUSIONS: Our approach resulted in a set of naturally expressed WT1 peptides and four TCRs that are promising candidates for TCR gene transfer strategies in patients with WT1-expressing tumors, including AML and ovarian carcinoma.
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