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:Antitumor CAR T-cell Screening Platform: Many Are Called, but Few Are Chosen.
表达嵌合抗原受体(CAR)的 T 细胞治疗是一种有前景的抗癌疗法。
嵌合抗原受体(CAR)T细胞治疗是一种有前景的抗癌疗法,但存在若干局限,目前尚未有效应用于实体瘤。Panowski及其同事的研究首次比较多个基于单链可变片段(scFv)的抗CD70 CAR-T细胞克隆,以开发治疗肾细胞癌(RCC)的临床产品。尽管CD70在T细胞上表达会带来T细胞自相残杀风险,研究者仍借助CD70保护性遮蔽现象成功制备CAR-T细胞。研究识别出两类CAR-T细胞,其记忆表型、活化状态和细胞毒活性各不相同。CD70 CAR-T在体外RCC细胞系和体内患者来源异种移植小鼠模型中均对RCC具有较强细胞毒性。通过组织交叉反应染色,以及食蟹猴抗CD3-CD70双特异性抗体临床前模型,证实了预期的淋巴细胞区室脱靶效应。先导CD70 CAR-T候选产品的疗效和毒性特征促使研究者推进规模化临床生产。本文强调CAR中的scFv会影响疗效与毒性的平衡。最终,研究者成功开发出一种高效治疗实体瘤的CAR-T候选产品,并通过异基因策略克服了扩大CAR-T应用的两大障碍。相关研究见Panowski等,2610页。
Treatment with T cells expressing chimeric antigen receptors (CAR) is a promising anticancer therapy. However, this approach has several limitations and has not yet been effectively applied to treat solid tumors. The study by Panowski and colleagues represents the first comparative analysis of multiple single chain fragment variable (scFv)-based anti-CD70 CAR T-cell clones for the development of a clinical product to treat renal cell carcinoma (RCC). Despite the risk of T-cell fratricide due to CD70 expression on T cells, CD70 CAR T cells were produced successfully thanks to the protective CD70 masking phenomenon. Two distinct classes of CAR T cells were identified with different memory phenotypes, activation statuses, and cytotoxic activity. CD70 CAR T cells presented high cytotoxic activity against RCC both in vitro in RCC cell lines and in vivo in patient-derived xenograft mouse models. The off-target effects expected on the lymphoid compartment were confirmed by tissue cross-reactivity staining and in a cynomolgus monkey preclinical model with CD3-CD70 bispecific antibody treatment. The efficacy and the toxicity profile of the lead CD70 CAR T-cell candidate instigated the researchers to proceed with upscaled clinical production. This article emphasizes the influence of the scFv of the CARs on their efficacy:toxicity balance. Ultimately, they successfully managed to develop a highly effective CAR T-cell candidate to treat a solid tumor by an allogeneic approach, thereby overcoming two major hurdles to broaden application of CAR T-cell therapy. See related article by Panowski et al., p. 2610.
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