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非病毒、特异性靶向 CAR-T 细胞在 B-NHL 中实现高安全性与疗效

英文原题:Non-viral, specifically targeted CAR-T cells achieve high safety and efficacy in B-NHL.

PubMed 2022/08/31(内容时间) Nature Q1 · IF 56.1(JCR 2025)

研究概要

我们的结果证明了非病毒、基因特异性整合 CAR-T 细胞的高安全性和有效性,从而为 CAR-T 细胞治疗提供了创新技术。

中文摘要

最近,嵌合抗原受体(CAR)-T细胞疗法在治疗血液系统恶性肿瘤方面显示出巨大前景1-7。然而,CAR-T细胞疗法目前仍存在若干局限性8-12。在此,我们成功开发了一种二合一方法,通过CRISPR-Cas9生成非病毒、基因特异性靶向的CAR-T细胞。使用优化后的方案,我们通过将抗CD19 CAR盒插入AAVS1安全港位点,在临床前研究中证明了其可行性。此外,我们开发了一种创新的抗CD19 CAR-T细胞类型,并整合了PD1,在异种移植模型中显示出更强的清除肿瘤细胞的能力。在对复发/难治性侵袭性B细胞非霍奇金淋巴瘤的过继治疗中(ClinicalTrials.gov,NCT04213469),我们在八名患者中观察到高比例(87.5%)的完全缓解和持久缓解,且未出现严重不良事件。值得注意的是,这些增强型CAR-T细胞即使在低输注剂量和低CAR+细胞比例下也有效。单细胞分析显示,电转方法使输注产品中记忆T细胞比例较高,而PD1干扰增强了抗肿瘤免疫功能,进一步验证了非病毒、PD1整合CAR-T细胞的优势。总体而言,我们的结果证明了非病毒、基因特异性整合CAR-T细胞的高安全性和有效性,从而为CAR-T细胞疗法提供了一种创新技术。

展开英文摘要原文

Recently, chimeric antigen receptor (CAR)-T cell therapy has shown great promise in treating haematological malignancies 1-7 . However, CAR-T cell therapy currently has several limitations 8-12 . Here we successfully developed a two-in-one approach to generate non-viral, gene-specific targeted CAR-T cells through CRISPR-Cas9. Using the optimized protocol, we demonstrated feasibility in a preclinical study by inserting an anti-CD19 CAR cassette into the AAVS1 safe-harbour locus. Furthermore, an innovative type of anti-CD19 CAR-T cell with PD1 integration was developed and showed superior ability to eradicate tumour cells in xenograft models. In adoptive therapy for relapsed/refractory aggressive B cell non-Hodgkin lymphoma (ClinicalTrials.gov, NCT04213469 ), we observed a high rate (87.5%) of complete remission and durable responses without serious adverse events in eight patients. Notably, these enhanced CAR-T cells were effective even at a low infusion dose and with a low percentage of CAR + cells. Single-cell analysis showed that the electroporation method resulted in a high percentage of memory T cells in infusion products, and PD1 interference enhanced anti-tumour immune functions, further validating the advantages of non-viral, PD1-integrated CAR-T cells. Collectively, our results demonstrate the high safety and efficacy of non-viral, gene-specific integrated CAR-T cells, thus providing an innovative technology for CAR-T cell therapy.

论文信息

作者
Zhang J、Hu Y、Yang J、Li W、Zhang M、Wang Q、Zhang L、Wei G
第一作者单位
Shanghai Frontiers Science Center of Genome Editing and Cell Therapy, Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China. zjqjeremy@163.com.China
通讯作者单位
Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. huanghe@zju.edu.cn.China
文献类型
临床试验
期刊
Nature2022 Sep
原文标识
PubMed 36045296 · DOI 10.1038/s41586-022-05140-y