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:Efficacy of CAR-T immunotherapy in MET overexpressing tumors not eligible for anti-MET targeted therapy.
Efficacy of CAR-T immunotherapy in MET overexpressing tumors not eligible for anti-MET targeted therapy.
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我们在临床前水平设定并验证了一种 MET-CAR 免疫治疗策略,该策略可能对不适合使用 MET 抑制性分子靶向治疗的癌症有益,包括那些表现出原发性或继发性耐药的癌症。
MET受体在癌症中的异常激活由遗传改变维持,或更常见地由转录上调维持。一部分MET扩增或突变的肿瘤对MET靶向药物敏感,但其反应性通常短暂,因为最终会出现继发性耐药。由于在缺乏遗传改变的情况下MET通常不是肿瘤驱动因素,MET过表达的肿瘤对MET靶向治疗无反应/反应差。因此,绝大多数表现出MET激活的肿瘤仍代表着一个未满足的医疗需求。
在此,我们提出一种基于表达靶向MET的嵌合抗原受体(CAR)的T淋巴细胞的免疫治疗策略,针对不同组织学类型的MET过表达肿瘤。我们构建了两种不同的MET-CAR结构,并测试了MET-CAR-T 细胞对不同MET过表达模型的细胞毒性活性,包括肿瘤细胞系、原代癌细胞、类器官以及免疫缺陷小鼠中的异种移植瘤。
我们证明了MET-CAR-T 对表达MET的细胞具有特异性细胞毒性活性。细胞杀伤与细胞表面MET表达水平成正比。虽然CAR-T 对携带生理水平MET的细胞的细胞毒性极小,基本上不伤害正常细胞,但对MET过表达肿瘤的活性很强,在体外和体内均能显著控制肿瘤细胞生长。值得注意的是,MET-CAR-T 细胞还能够打破MET扩增癌细胞中对MET靶向药物获得的耐药性,这些癌细胞在下游信号转导因子中携带继发性突变。
Aberrant activation of the MET receptor in cancer is sustained by genetic alterations or, more frequently, by transcriptional upregulations. A fraction of MET-amplified or mutated tumors are sensible to MET targeting agents, but their responsiveness is typically short-lasting, as secondary resistance eventually occurs. Since in the absence of genetic alterations MET is usually not a tumor driver, MET overexpressing tumors are not/poorly responsive to MET targeted therapies. Consequently, the vast majority of tumors exhibiting MET activation still represent an unmet medical need.
Here we propose an immunotherapy strategy based on T lymphocytes expressing a Chimeric Antigen Receptor (CAR) targeting MET overexpressing tumors of different histotypes. We engineered two different MET-CAR constructs and tested MET-CAR-T cell cytotoxic activity against different MET overexpressing models, including tumor cell lines, primary cancer cells, organoids, and xenografts in immune-deficient mice.
We proved that MET-CAR-T exerted a specific cytotoxic activity against MET expressing cells. Cell killing was proportional to the level of MET expressed on the cell surface. While CAR-T cytotoxicity was minimal versus cells carrying MET at physiological levels, essentially sparing normal cells, the activity versus MET overexpressing tumors was robust, significantly controlling tumor cell growth in vitro and in vivo. Notably, MET-CAR-T cells were also able to brake acquired resistance to MET targeting agents in MET amplified cancer cells carrying secondary mutations in downstream signal transducers.
We set and validated at the pre-clinical level a MET-CAR immunotherapy strategy potentially beneficial for cancers not eligible for MET targeted therapy with inhibitory molecules, including those exhibiting primary or secondary resistance.
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