基于 DNA 超分子水凝胶的保护性 NK 细胞储库用于增强三阴性乳腺癌治疗
Protective NK Cell Reservoir Based on DNA Supramolecular Hydrogel for Enhanced Triple-Negative Breast Cancer Therapy.
过继性自然杀伤(NK)细胞疗法是治疗三阴性乳腺癌的一种有前景的策略,但其疗效往往受到瘤内持久性差以及在免疫抑制性肿瘤微环境中功能耗竭的限制。
英文原题:Multi-antigen-targeted T-cell therapy to treat patients with relapsed/refractory breast cancer.
MultiTAA T细胞耐受性良好,并在一位难治性BC患者中诱导了疾病稳定。这与体内T细胞扩增、持续存在和抗原扩散相关。该方法的未来方向可能包括增强multiTAA T细胞在BC患者中治疗获益的额外策略。
过继转移的、体外扩增的多抗原靶向T细胞(multiTAA-T)代表了一种新的、可能有效且无毒的治疗方法,用于乳腺癌(BC)患者。在这项首次人体试验中,我们研究了向复发/难治/转移性BC患者施用靶向肿瘤表达抗原Survivin、NY-ESO-1、MAGE-A4、SSX2和PRAME的多抗原T细胞的安全性和临床效果。
MultiTAA T细胞产品由既往接受过大量治疗的转移性或局部复发性不可切除BC患者(涵盖所有亚型)的外周血制备,并以2 × 10 7 /m 2 的固定剂量水平输注。患者接受两次细胞输注,间隔4周,并评估安全性和临床活性。细胞在门诊环境中给药,且未进行预先的淋巴细胞清除化疗。
所有患者均为雌激素受体/孕激素受体阳性BC,其中1例同时为人表皮生长因子受体2阳性。未发生治疗相关毒性,输注耐受良好。在入组并接受multiTAA T细胞输注的10例经重度预处理患者中,9例出现疾病进展,而1例既往接受过10线治疗的患者获得了较长时间(5个月)的疾病稳定,这与针对靶抗原的T细胞在体内扩增和持续存在相关。此外,在7/10例患者中,multiTAA输注后观察到抗原扩散以及针对一系列非靶向肿瘤抗原的T细胞内源性激活。
PURPOSE: Adoptively transferred, ex vivo expanded multi-antigen-targeted T cells (multiTAA-T) represent a new, potentially effective, and nontoxic therapeutic approach for patients with breast cancer (BC). In this first-in-human trial, we investigated the safety and clinical effects of administering multiTAA T cells targeting the tumor-expressed antigens, Survivin, NY-ESO-1, MAGE-A4, SSX2, and PRAME, to patients with relapsed/refractory/metastatic BC. MATERIALS AND METHODS: MultiTAA T-cell products were generated from the peripheral blood of heavily pre-treated patients with metastatic or locally recurrent unresectable BC of all subtypes and infused at a fixed dose level of 2 × 10 7 /m 2 . Patients received two infusions of cells 4 weeks apart and safety and clinical activity were determined. Cells were administered in an outpatient setting and without prior lymphodepleting chemotherapy. RESULTS: All patients had estrogen receptor/progesterone receptor positive BC, with one patient also having human epidermal growth factor receptor 2-positive. There were no treatment-related toxicities and the infusions were well tolerated. Of the 10 heavily pre-treated patients enrolled and infused with multiTAA T cells, nine had disease progression while one patient with 10 lines of prior therapies experienced prolonged (5 months) disease stabilization that was associated with the in vivo expansion and persistence of T cells directed against the targeted antigens. Furthermore, antigen spreading and the endogenous activation of T cells directed against a spectrum of non-targeted tumor antigens were observed in 7/10 patients post-multiTAA infusion. CONCLUSION: MultiTAA T cells were well tolerated and induced disease stabilization in a patient with refractory BC. This was associated with in vivo T-cell expansion, persistence, and antigen spreading. Future directions of this approach may include additional strategies to enhance the therapeutic benefit of multiTAA T cells in patients with BC.
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