γδ T 细胞调节小细胞肺癌中的抗肿瘤免疫
γδ T cells modulate anti-tumor immunity in small cell lung cancer.
我们的发现表明,活化的γδ T细胞可能是SCLC治疗的有价值靶点。
英文原题:A phase I/II escalation trial design T-RAD: Treatment of metastatic lung cancer with mRNA-engineered T cells expressing a T cell receptor targeting human telomerase reverse transcriptase (hTERT).
转移性NSCLC的治疗手段匮乏,对新的个性化治疗方案需求迫切。hTERT是一种适用于多种癌症类型的肿瘤靶点。这项概念验证研究将首次探索靶向hTERT的TCR mRNA电转染自体T细胞的安全性和有效性。因此,T-RAD研究将评估一种有吸引力的实体瘤未来免疫治疗候选方案。
过继性细胞治疗(ACT)使用基因修饰的T细胞,旨在通过引入T细胞受体(TCR)使T细胞靶向耐药性癌症。Radium-4 TCR是从一项癌症疫苗接种研究中一名有应答的患者体内分离得到的,可识别呈递于MHC II类分子(HLA-DP04)上的人端粒酶逆转录酶(hTERT)酶活性组分。hTERT是一种组成性过表达的肿瘤相关抗原,存在于大多数人类癌症中,包括非小细胞肺癌(NSCLC),后者是全球第二常见的癌症类型。复发性NSCLC的治疗选择有限,生存率低。为改善患者预后,我们设计了一项靶向hTERT的基于TCR的ACT研究。
T-RAD 是一项 I/II 期研究,旨在评估镭-4 mRNA 电穿孔自体 T 细胞在无其他治疗选择的转移性 NSCLC 治疗中的安全性和有效性。出于安全性考虑,采用瞬时 TCR 表达。受试者接受两次静脉注射,剂量递增的重定向 T 细胞每周一次,连续 6 周。主要目标是安全性和耐受性。次要目标包括无进展生存期、至进展时间、总生存期、患者报告结局和总体影像学缓解。
BACKGROUND: Adoptive cellular therapy (ACT) with genetically modified T cells aims to redirect T cells against resistant cancers through introduction of a T cell receptor (TCR). The Radium-4 TCR was isolated from a responding patient in a cancer vaccination study and recognizes the enzymatic component of human Telomerase Reverse Transcriptase (hTERT) presented on MHC class II (HLA-DP04). hTERT is a constitutively overexpressed tumor-associated antigen present in most human cancers, including non-small-cell lung cancer (NSCLC), which is the second most common type of cancer worldwide. Treatment alternatives for relapsing NSCLC are limited and survival is poor. To improve patient outcome we designed a TCR-based ACT study targeting hTERT. METHODS: T-RAD is a phase I/II study to evaluate the safety and efficacy of Radium-4 mRNA electroporated autologous T cells in the treatment of metastatic NSCLC with no other treatment option. Transient TCR expression is applied for safety considerations. Participants receive two intravenous injections with escalating doses of redirected T cells weekly for 6 consecutive weeks. Primary objectives are safety and tolerability. Secondary objectives include progression-free survival, time to progression, overall survival, patient reported outcomes and overall radiological response. DISCUSSION: Treatment for metastatic NSCLC is scarce and new personalized treatment options are in high demand. hTERT is a tumor target applicable to numerous cancer types. This proof-of-concept study will explore for the first time the safety and efficacy of TCR mRNA electroporated autologous T cells targeting hTERT. The T-RAD study will thus evaluate an attractive candidate for future immunotherapy of solid tumors.
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