CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Characteristics of anti-CLL1 based CAR-T therapy for children with relapsed or refractory acute myeloid leukemia: the multi-center efficacy and safety interim analysis.
Characteristics of anti-CLL1 based CAR-T therapy for children with relapsed or refractory acute myeloid leukemia: the multi-center efficacy and safety interim analysis.
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C型凝集素样分子-1(CLL1)优先表达于急性髓系白血病(AML)干细胞和AML原始细胞,可被视为AML相关抗原。基于抗CLL1的CAR-T 细胞在体外和AML荷瘤小鼠模型中均表现出有效的肿瘤杀伤能力。在本报告中,招募了8例复发/难治性AML(R/R-AML)患儿,参加自体抗CLL1 CAR-T 细胞免疫治疗的1/2期临床试验。本临床试验的目的是评估抗CLL1 CAR-T 细胞治疗的安全性和初步疗效。患者在淋巴细胞清除预处理后接受一剂自体抗CLL1 CAR-T 细胞。CAR-T 治疗后,患者发生1-2级细胞因子释放综合征(CRS),但无任何致死性事件。8例患者中有4例达到形态学无白血病状态(MLFS)且微小残留病(MRD)阴性,1例为MLFS且MRD阳性,1例达到完全缓解但血细胞计数未完全恢复(CRi)但MRD阳性,1例为部分缓解(PR),1例维持疾病稳定(SD)状态但CLL1阳性AML原始细胞清除。这些结果提示,基于抗CLL1的CAR-T 细胞免疫治疗可被视为治疗R/R-AML患儿的一种耐受性良好且有效的选择。
C-type lectin-like molecule-1 (CLL1) is preferentially expressed on acute myeloid leukemia (AML) stem cells and AML blasts, which can be considered as AML-associated antigen. Anti-CLL1-based CAR-T cells exhibited effective tumor-killing capacity in vitro and in AML-bearing mouse model. In this report, eight children with relapsed or refractory AML (R/R-AML) were recruited for a phase 1/2 clinical trial of autologous anti-CLL1 CAR-T cell immunotherapy. The objectives of this clinical trial were to evaluate the safety and the preliminary efficacy of anti-CLL1 CAR-T cell treatment. Patients received one dose of autologous anti-CLL1 CAR-T cells after lymphodepletion conditioning.
After CAR-T treatment, patients developed grade 1-2 cytokine release syndrome (CRS) but without any lethal events. 4 out of 8 patients achieved morphologic leukemia-free state (MLFS) and minimal residual disease (MRD) negativity, 1 patient with MLFS and MRD positivity, 1 patient achieved complete remission with incomplete hematologic recovery (CRi) but MRD positivity, 1 patient with partial remission (PR), and 1 patient remained at stable disease (SD) status but had CLL1-positive AML blast clearance.
These results suggested that anti-CLL1-based CAR-T cell immunotherapy can be considered as a well-tolerated and effective option for treating children with R/R-AML.
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