不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
肿瘤细胞治疗研究
英文原题:A novel antibody-TCR (AbTCR) T-cell therapy is safe and effective against CD19-positive relapsed/refractory B-cell lymphoma.
A novel antibody-TCR (AbTCR) T-cell therapy is safe and effective against CD19-positive relapsed/refractory B-cell lymphoma.
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本研究为 AbTCR 平台作为一种新型癌症治疗手段提供了初步临床验证,该平台有潜力以低毒性带来持久临床获益。
嵌合抗原受体(CAR)T细胞疗法广泛应用的障碍之一是毒性。为此,研究团队近期开发了新型抗体-T细胞受体(AbTCR)平台(商标名ARTEMIS),旨在利用天然免疫受体信号和调节机制。该平台包括基于γδ TCR的AbTCR构建体及一个独立共刺激分子,二者均经过肿瘤特异性工程化。本研究评估靶向CD19的AbTCR T细胞疗法的安全性和初步疗效。
研究制备自体CD19靶向AbTCR T细胞ET019003,并开展早期I期研究,评估其治疗CD19阳性复发/难治性(r/r)B细胞淋巴瘤的安全性和初步疗效。
16名患者入组,其中12名接受治疗。治疗患者中,6人(50%)完全缓解,4人(33%)部分缓解,最佳客观缓解率为83%。完全缓解持久,包括2名患者分别持续缓解22.7个月和23.2个月。ET019003耐受性良好,安全特征较理想;无患者发生重度(3级)细胞因子释放综合征(CRS),仅1人发生任何级别免疫效应细胞相关神经毒性综合征(ICANS)。即使ET019003 T细胞显著扩增,患者细胞因子水平也未明显升高。
本研究初步临床验证AbTCR平台可作为新型癌症治疗方法,有望在毒性较低的同时带来持久临床获益。试验注册号:NCT03642496,注册日期:2018年8月22日。
A barrier to widespread adoption of chimeric antigen receptor (CAR) T-cell therapy is toxicity. To address this, we recently developed a novel antibody-T-cell receptor (AbTCR) platform (trademarked as ARTEMIS ) which was designed to leverage natural immune receptor signaling and regulation. The AbTCR platform includes a gamma/delta ( ) TCR-based AbTCR construct and a separate co-stimulatory molecule, both engineered to be tumor-specific. Here, we aim to assess the safety and preliminary efficacy of a CD19-directed AbTCR T-cell therapy.
We generated ET019003 T cells, which are autologous CD19-directed AbTCR T cells. We then conducted an early phase I study to evaluate the safety and preliminary efficacy of ET019003 T cells for the treatment of CD19-positive relapsed/refractory (r/r) B-cell lymphoma.
Sixteen patients enrolled in this study and 12 patients were treated. Of the 12 patients treated, 6 patients (50%) achieved a complete response (CR), and 4 (33%) achieved a partial response (PR) (best objective response rate [ORR] of 83%). CRs were durable, including 2 patients with ongoing CRs for 22.7 months and 23.2 months. ET019003 was well-tolerated with an attractive safety profile. No patients experienced severe (grade 3) cytokine release syndrome (CRS) and only 1 patient experienced immune effector cell-associated neurotoxicity syndrome (ICANS) of any grade. Significant elevations of cytokine levels were not seen, even in patients with marked expansion of ET019003 T cells.
This study provides initial clinical validation of the AbTCR platform as a novel cancer treatment with the potential to provide durable clinical benefit with low toxicity. TRIAL REGISTRATION: NCT03642496; Date of registration: August 22, 2018.
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