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:Expanding anti-CD38 immunotherapy for lymphoid malignancies.
这些发现可能将抗 CD38 免疫治疗拓展至广泛的淋巴系统恶性肿瘤,并提示应将 ATRA 纳入 daratumumab 或其他抗 CD38 免疫制剂用于癌症治疗。
背景:多发性骨髓瘤(MM)、非霍奇金淋巴瘤(NHL)及NK/T细胞肿瘤等淋巴系肿瘤,是血癌患者发病和死亡的重要原因。CD38(环状ADP核糖水解酶)是跨膜糖蛋白,表达于浆细胞和MM细胞表面。CD38在MM及其他淋巴系恶性肿瘤中高表达,而在正常组织中表达受限,因此是有吸引力的免疫治疗靶点。靶向CD38的抗体(如达雷妥尤单抗)已获批治疗MM,也在多项淋巴瘤和白血病临床试验中接受评估。方法:研究者构建靶向CD38的嵌合抗原受体(CAR)T细胞,并检测其对多种CD38高表达和低表达淋巴系癌细胞的细胞毒性。评估全反式维甲酸(ATRA)与CAR-T或达雷妥尤单抗联合对癌细胞及异种移植瘤的协同作用。结果:CD38-CAR-T细胞在体外和小鼠异种移植模型中均显著抑制CD38高表达MM、套细胞淋巴瘤(MCL)、华氏巨球蛋白血症(WM)、T细胞急性淋巴细胞白血病(T-ALL)和NK/T细胞淋巴瘤(NKTCL)生长。ATRA可提高多种CD38低表达癌细胞的CD38表达,并增强达雷妥尤单抗和CD38-CAR-T细胞在异种移植瘤中的抗肿瘤活性。结论:这些发现有望将抗CD38免疫疗法拓展至多种淋巴系恶性肿瘤,并支持将ATRA纳入达雷妥尤单抗或其他抗CD38免疫治疗药物的癌症治疗方案。
BACKGROUND: Lymphoid neoplasms, including multiple myeloma (MM), non-Hodgkin lymphoma (NHL), and NK/T cell neoplasms, are a major cause of blood cancer morbidity and mortality. CD38 (cyclic ADP ribose hydrolase) is a transmembrane glycoprotein expressed on the surface of plasma cells and MM cells. The high expression of CD38 across MM and other lymphoid malignancies and its restricted expression in normal tissues make CD38 an attractive target for immunotherapy. CD38-targeting antibodies, like daratumumab, have been approved for the treatment of MM and tested against lymphoma and leukemia in multiple clinical trials. METHODS: We generated chimeric antigen receptor (CAR) T cells targeting CD38 and tested its cytotoxicity against multiple CD38 high and CD38 low lymphoid cancer cells. We evaluated the synergistic effects of all-trans retinoic acid (ATRA) and CAR T cells or daratumumab against cancer cells and xenograft tumors. RESULTS: CD38-CAR T cells dramatically inhibited the growth of CD38 high MM, mantle cell lymphoma (MCL), Waldenstrom's macroglobulinemia (WM), T-cell acute lymphoblastic leukemia (T-ALL), and NK/T-cell lymphoma (NKTCL) in vitro and in mouse xenografts. ATRA elevated CD38 expression in multiple CD38 low cancer cells and enhanced the anti-tumor activity of daratumumab and CD38-CAR T cells in xenograft tumors. CONCLUSIONS: These findings may expand anti-CD38 immunotherapy to a broad spectrum of lymphoid malignancies and call for the incorporation of ATRA into daratumumab or other anti-CD38 immunological agents for cancer therapy.
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