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