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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Immune phenotypes and checkpoint molecule expression of clonally expanded lymph node-infiltrating T cells in classical Hodgkin lymphoma.
Immune phenotypes and checkpoint molecule expression of clonally expanded lymph node-infiltrating T cells in classical Hodgkin lymphoma.
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淋巴结浸润性 T 细胞在经典霍奇金淋巴瘤(cHL)中一直备受关注。抗体介导的免疫检查点阻断治疗即使对复发/难治性患者也具有高完全缓解率,提示存在一个以 T 细胞为主、抗原经验丰富、功能受抑制且靶向淋巴瘤的免疫微环境。
我们探究了克隆扩增的 T 细胞是否(1)可在 cHL 淋巴结中检测到,(2)表现出特征性的免疫表型,以及(3)受到免疫检查点分子表达的抑制。
我们对来自 10 例初治患者的淋巴结浸润性 T 细胞应用了高维 FACS 索引分选和单细胞 T 细胞受体 αβ 测序。T 细胞以 CD4+ 为主,并表现出记忆分化。经典免疫检查点分子(CTLA-4、PD-1、TIM-3)的表达普遍较低(< 12.0% 的 T 细胞),且在 CD4+ 和 CD8+ T 细胞之间无差异。克隆性 T 细胞扩增的程度在患者间存在差异(范围:每例患者 1-18 个扩增克隆),且几乎仅局限于 CD8+ T 细胞。克隆扩增的 T 细胞表现出非初始表型和低检查点分子表达,与未扩增的 T 细胞相似。
我们的数据提示,免疫检查点阻断的治疗效果需要除解除对已有淋巴瘤靶向 T 细胞反应的抑制之外的机制。未来关于免疫检查点阻断相关效应的研究将确定分子 T 细胞靶点,探讨细胞组成随时间的动态变化,并将其关注范围扩展到淋巴结浸润性 T 细胞之外。
Lymph node-infiltrating T cells have been of particular interest in classical Hodgkin lymphoma (cHL). High rates of complete therapeutic responses to antibody-mediated immune checkpoint blockade, even in relapsed/refractory patients, suggest the existence of a T cell-dominated, antigen-experienced, functionally inhibited and lymphoma-directed immune microenvironment.
We asked whether clonally expanded T cells (1) were detectable in cHL lymph nodes, (2) showed characteristic immune phenotypes, and (3) were inhibited by immune checkpoint molecule expression.
We applied high-dimensional FACS index sorting and single cell T cell receptor αβ sequencing to lymph node-infiltrating T cells from 10 treatment-naïve patients. T cells were predominantly CD4 + and showed memory differentiation. Expression of classical immune checkpoint molecules (CTLA-4, PD-1, TIM-3) was generally low (< 12.
0% of T cells) and not different between CD4 + and CD8 + T cells. Degrees of clonal T cell expansion varied between patients (range: 1-18 expanded clones per patient) and was almost exclusively restricted to CD8 + T cells. Clonally expanded T cells showed non-naïve phenotypes and low checkpoint molecule expression similar to non-expanded T cells.
Our data suggest that the therapeutic effects of immune checkpoint blockade require mechanisms in addition to dis-inhibition of pre-existing lymphoma-directed T cell responses. Future studies on immune checkpoint blockade-associated effects will identify molecular T cell targets, address dynamic aspects of cell compositions over time, and extend their focus beyond lymph node-infiltrating T cells.
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