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:Dual antigen-targeted off-the-shelf NK cells show durable response and prevent antigen escape in lymphoma and leukemia.
Dual antigen-targeted off-the-shelf NK cells show durable response and prevent antigen escape in lymphoma and leukemia.
大量B细胞白血病和淋巴瘤患者由于抗CD19嵌合抗原受体(CAR)T细胞治疗后的抗原丢失或异质性而复发。
大量B细胞白血病和淋巴瘤患者因抗CD19嵌合抗原受体(CAR)T细胞治疗后出现抗原丢失或异质性而复发。为克服抗原逃逸并解决抗原异质性问题,我们工程化改造了诱导多能干细胞来源的NK细胞,使其同时表达一种经NK细胞优化的抗CD19 CAR以直接靶向,以及一种高亲和力、不可切割的CD16以增强抗体依赖性细胞毒性。此外,我们引入了一种膜结合型IL-15/IL-15R融合蛋白以促进体内持久性。这些工程化细胞,称为iDuo NK细胞,表现出强健的CAR介导的细胞毒性活性,且可通过靶向B细胞恶性肿瘤的治疗性抗体进一步增强。在多种体外和异种过继转移模型中,iDuo NK细胞表现出强健的抗淋巴瘤活性。此外,iDuo NK细胞有效清除了CD19+和CD19-淋巴瘤细胞,并表现出独特的倾向,即优先靶向恶性细胞而非表达CD19的健康细胞,这些特征为抗CAR19 T细胞所无法实现。iDuo NK细胞联合治疗性抗体代表了一种有前景的方法,可预防B细胞恶性肿瘤患者因抗原丢失和肿瘤异质性导致的复发。
Substantial numbers of B cell leukemia and lymphoma patients relapse due to antigen loss or heterogeneity after anti-CD19 chimeric antigen receptor (CAR) T cell therapy. To overcome antigen escape and address antigen heterogeneity, we engineered induced pluripotent stem cell-derived NK cells to express both an NK cell-optimized anti-CD19 CAR for direct targeting and a high affinity, non-cleavable CD16 to augment antibody-dependent cellular cytotoxicity. In addition, we introduced a membrane-bound IL-15/IL-15R fusion protein to promote in vivo persistence. These engineered cells, termed iDuo NK cells, displayed robust CAR-mediated cytotoxic activity that could be further enhanced with therapeutic antibodies targeting B cell malignancies. In multiple in vitro and xenogeneic adoptive transfer models, iDuo NK cells exhibited robust anti-lymphoma activity. Furthermore, iDuo NK cells effectively eliminated both CD19+ and CD19- lymphoma cells and displayed a unique propensity for targeting malignant cells over healthy cells that expressed CD19, features not achievable with anti-CAR19 T cells. iDuo NK cells combined with therapeutic antibodies represent a promising approach to prevent relapse due to antigen loss and tumor heterogeneity in patients with B cell malignancies.
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