不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Sleeping beauty generated CD19 CAR T-Cell therapy for advanced B-Cell hematological malignancies.
Sleeping beauty generated CD19 CAR T-Cell therapy for advanced B-Cell hematological malignancies.
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嵌合抗原受体(CAR)T细胞疗法近期已成为复发/难治性急性淋巴细胞白血病(ALL)及几种B细胞非霍奇金淋巴瘤(NHL)亚型患者的标准治疗。
然而,鉴于其给药复杂性和相关毒性,其使用仍局限于高度专业化的中心。我们此前报道了在移植围期使用新型Sleeping Beauty(SB)CD19特异性CAR-T 细胞疗法的经验,该疗法表现出优异的安全性特征和令人鼓舞的生存结局。此后,我们修改了SB CD19 CAR构建体以提高其疗效并缩短其生产时间。
我们在此报告1期临床试验的安全性结果。14例经过大量治疗的复发/难治性ALL和NHL患者接受了输注。总体而言,没有严重不良事件直接归因于研究治疗。3例患者发生1-2级细胞因子释放综合征,没有研究患者出现神经毒性。所有剂量水平均耐受良好,未报告剂量限制性毒性。在疗效方面,8例ALL患者中有3例(38%)达到CR/CRi(完全缓解伴计数未完全恢复),1例(13%)患者持续分子学疾病阳性。4例DLBCL患者中,2例(50%)达到CR。基于SB的CAR构建体允许生产安全、具有成本效益且具有令人鼓舞的抗肿瘤活性的靶向CAR-T 细胞疗法。
Chimeric antigen receptor (CAR) T-cell therapy has emerged recently as a standard of care treatment for patients with relapsed or refractory acute lymphoblastic leukemia (ALL) and several subtypes of B-cell non-Hodgkin lymphoma (NHL).
However, its use remains limited to highly specialized centers, given the complexity of its administration and its associated toxicities.
We previously reported our experience in using a novel Sleeping Beauty (SB) CD19-specific CAR T-cell therapy in the peri-transplant setting, where it exhibited an excellent safety profile with encouraging survival outcomes.
We have since modified the SB CD19 CAR construct to improve its efficacy and shorten its manufacturing time.
We report here the phase 1 clinical trial safety results. Fourteen heavily treated patients with relapsed/refractory ALL and NHL were infused.
Overall, no serious adverse events were directly attributed to the study treatment. Three patients developed grades 1-2 cytokine release syndrome and none of the study patients experienced neurotoxicity. All dose levels were well tolerated and no dose-limiting toxicities were reported.
For efficacy, 3 of 8 (38%) patients with ALL achieved CR/CRi (complete remission with incomplete count recovery) and 1 (13%) patient had sustained molecular disease positivity. Of the 4 patients with DLBCL, 2 (50%) achieved CR. The SB-based CAR constructs allow manufacturing of targeted CAR T-cell therapies that are safe, cost-effective and with encouraging antitumor activity.
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