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用于治疗复发或难治性非霍奇金淋巴瘤的初始/记忆 T 细胞中 CD19/CD20 双特异性嵌合抗原受体 (CAR)

英文原题:CD19/CD20 Bispecific Chimeric Antigen Receptor (CAR) in Naive/Memory T Cells for the Treatment of Relapsed or Refractory Non-Hodgkin Lymphoma.

PubMed 2023/03/01(内容时间) Cancer Discov Q1 · IF 29.5(JCR 2025)

研究概要

CART19/20 TN/MEM 细胞在复发/难治性 NHL 患者中安全有效,在低剂量水平即可实现持久缓解。

中文摘要

未标注:为解决抗原逃逸和T细胞功能丧失的问题,我们报告了一项I期临床试验(NCT04007029),评估自体初始和记忆T(TN/MEM)细胞经工程化表达双特异性抗CD19/CD20嵌合抗原受体(CAR;CART19/20)用于复发/难治性非霍奇金淋巴瘤(NHL)患者,以安全性为主要终点。10例患者接受了36×10^6至165×10^6个CART19/20细胞治疗。没有患者出现任何级别的神经毒性或超过1级的细胞因子释放综合征。观察到1例剂量限制性毒性(持续性血细胞减少)。10例患者中有9例达到客观缓解[90%总缓解率(ORR)],其中7例达到完全缓解[70%完全缓解(CR)率]。1例患者在CR 18个月后复发,但在接受第二剂CART19/20细胞后恢复CR。中位无进展生存期为18个月,中位总生存期未达到,中位随访时间为17个月。总之,CART19/20 TN/MEM细胞在复发/难治性NHL患者中安全有效,在低剂量水平即可实现持久缓解。意义:用于NHL患者的由TN/MEM细胞生成的自体CD19/CD20双特异性CAR-T细胞疗法是安全的(无神经毒性,最高1级细胞因子释放综合征),并在首次人体I期剂量递增试验中显示出强效(90% ORR,70% CR率)。本文在《本期特写》第517页中予以重点介绍。

展开英文摘要原文

UNLABELLED: To address antigen escape and loss of T-cell functionality, we report a phase I clinical trial (NCT04007029) evaluating autologous naive and memory T (TN/MEM) cells engineered to express a bispecific anti-CD19/CD20 chimeric antigen receptor (CAR; CART19/20) for patients with relapsed/refractory non-Hodgkin lymphoma (NHL), with safety as the primary endpoint. Ten patients were treated with 36 106 to 165 106 CART19/20 cells. No patient experienced neurotoxicity of any grade or over grade 1 cytokine release syndrome. One case of dose-limiting toxicity (persistent cytopenia) was observed. Nine of 10 patients achieved objective response [90% overall response rate (ORR)], with seven achieving complete remission [70% complete responses (CR) rate]. One patient relapsed after 18 months in CR but returned to CR after receiving a second dose of CART19/20 cells. Median progression-free survival was 18 months and median overall survival was not reached with a 17-month median follow-up. In conclusion, CART19/20 TN/MEM cells are safe and effective in patients with relapsed/refractory NHL, with durable responses achieved at low dosage levels. SIGNIFICANCE: Autologous CD19/CD20 bispecific CAR-T cell therapy generated from TN/MEM cells for patients with NHL is safe (no neurotoxicity, maximum grade 1 cytokine release syndrome) and demonstrates strong efficacy (90% ORR, 70% CR rate) in a first-in-human, phase I dose-escalation trial. This article is highlighted in the In This Issue feature, p. 517.

论文信息

作者
Larson SM、Walthers CM、Ji B、Ghafouri SN、Naparstek J、Trent J、Chen JM、Roshandell M
第一作者单位
Department of Medicine, Division of Hematology-Oncology, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California.United States
通讯作者单位
Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California.United States
文献类型
非美国政府资助研究 · 美国 NIH 资助研究
期刊
Cancer discovery2023 Mar 1
原文标识
PubMed 36416874 · DOI 10.1158/2159-8290.CD-22-0964