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:Chemoimmunotherapy Administration Protocol Design for the Treatment of Leukemia through Mathematical Modeling and In Silico Experimentation.
具有 200 多种变体的癌症仍是全球主要的健康问题,2020 年记录的死亡人数接近 1000 万,根据 Global Cancer Observatory 的数据,白血病占 30 多万例。
癌症有200多种类型,仍是全球重大健康问题;全球癌症观察站数据显示,2020年癌症死亡人数近1,000万,白血病病例超过30万。尽管多项临床试验正在开发新的治疗策略,癌症演进及其生存机制仍十分复杂,仍需深入研究以进一步优化疗法应用。本研究采用一阶常微分方程构建非线性动力系统,探索嵌合抗原受体(CAR)T细胞联合苯丁酸氮芥治疗癌症(尤其是慢性淋巴细胞白血病)的生长动力学。基于非线性理论,研究建立了白血病细胞清除的充分条件,以及CAR-T细胞和癌细胞长期持续存在的必要条件。持续存在条件对治疗方案设计很重要,因为它们可确定剂量阈值;低于该阈值时,药量不足以对肿瘤群体产生细胞毒作用。计算机模拟实验用于设计给药方案,以确保所研究系统中的白血病细胞彻底清除,分别考虑CAR-T细胞单独输注和化学免疫联合治疗。所有结果均通过数值模拟展示。研究还建立并详细讨论了估算苯丁酸氮芥和CAR-T细胞对白血病癌细胞细胞毒性的方程,并为各公式参数给出95%置信区间。
Cancer with all its more than 200 variants continues to be a major health problem around the world with nearly 10 million deaths recorded in 2020, and leukemia accounted for more than 300,000 cases according to the Global Cancer Observatory. Although new treatment strategies are currently being developed in several ongoing clinical trials, the high complexity of cancer evolution and its survival mechanisms remain as an open problem that needs to be addressed to further enhanced the application of therapies. In this work, we aim to explore cancer growth, particularly chronic lymphocytic leukemia, under the combined application of CAR-T cells and chlorambucil as a nonlinear dynamical system in the form of first-order Ordinary Differential Equations. Therefore, by means of nonlinear theories, sufficient conditions are established for the eradication of leukemia cells, as well as necessary conditions for the long-term persistence of both CAR-T and cancer cells. Persistence conditions are important in treatment protocol design as these provide a threshold below which the dose will not be enough to produce a cytotoxic effect in the tumour population. In silico experimentations allowed us to design therapy administration protocols to ensure the complete eradication of leukemia cells in the system under study when considering only the infusion of CAR-T cells and for the combined application of chemoimmunotherapy. All results are illustrated through numerical simulations. Further, equations to estimate cytotoxicity of chlorambucil and CAR-T cells to leukemia cancer cells were formulated and thoroughly discussed with a 95% confidence interval for the parameters involved in each formula.
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