下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:A phase 1 trial of NY-ESO-1-specific TCR-engineered T-cell therapy combined with a lymph node-targeting nanoparticulate peptide vaccine for the treatment of advanced soft tissue sarcoma.
不经淋巴细胞清除的 NY-ESO-1 特异性 TCR-T 细胞疗法联合携带含 NY-ESO-1 表位的 LPA 的普鲁兰纳米凝胶疫苗接种是可行的,并可在难治性 SS 中诱导有前景的持久疗效(注册号:JMA-IIA00346)。
免疫检查点抑制剂治疗难治性实体瘤的疗效有限。T细胞受体基因修饰T(TCR-T)细胞疗法作为治疗难治性“冷肿瘤”的新型免疫疗法,已受到关注。我们首先在对免疫检查点阻断耐药的小鼠肉瘤模型中,研究TCR-T细胞联合pullulan纳米凝胶:长肽抗原(LPA)疫苗的临床前疗效和作用机制。未进行淋巴细胞清除时,pullulan纳米凝胶:LPA疫苗显著增加引流淋巴结和肿瘤组织中的TCR-T细胞数量,并伴随引流淋巴结TCR-T细胞CXCR3表达增强。在I期试验中,将自体纽约食管鳞状细胞癌1(NY-ESO-1)特异性TCR-T细胞输注两次给HLA匹配、患NY-ESO-1⁺软组织肉瘤(STS)的患者。pullulan纳米凝胶:LPA疫苗含有TCR-T细胞识别的表位,于TCR-T细胞输注前1天及输注后7天皮下注射,未进行淋巴细胞清除。3名难治性滑膜肉瘤(SS)患者接受治疗,其中2名发生细胞因子释放综合征(CRS),细胞因子水平轻至中度升高。通过肿瘤影像发现其中1名患者肿瘤明显缩小,持续超过2年;该患者TCR-T细胞也长期持续存在。总之,NY-ESO-1特异性TCR-T细胞疗法联合携带NY-ESO-1表位LPA的pullulan纳米凝胶疫苗,且不进行淋巴细胞清除,是可行的,并可在难治性SS中诱导有希望的持久治疗效果(注册号:JMA-IIA00346)。
The efficacy of immune checkpoint inhibitors is limited in refractory solid tumors. T-cell receptor gene-modified T (TCR-T)-cell therapy has attracted attention as a new immunotherapy for refractory cold tumors. We first investigated the preclinical efficacy and mode of action of TCR-T cells combined with the pullulan nanogel:long peptide antigen (LPA) vaccine in a mouse sarcoma model that is resistant to immune checkpoint inhibition. Without lymphodepletion, the pullulan nanogel:LPA vaccine markedly increased the number of TCR-T cells in the draining lymph node and tumor tissue. This change was associated with enhanced CXCR3 expression in TCR-T cells in the draining lymph node. In the phase 1 trial, autologous New York esophageal squamous cell carcinoma 1 (NY-ESO-1)-specific TCR-T cells were infused twice into HLA-matched patients with NY-ESO-1 + soft tissue sarcoma (STS). The pullulan nanogel:LPA vaccine contains an epitope recognized by TCR-T cells, and it was subcutaneously injected 1 day before and 7 days after the infusion of TCR-T cells. Lymphodepletion was not performed. Three patients with refractory synovial sarcoma (SS) were treated. Two out of the three patients developed cytokine release syndrome (CRS) with low-to-moderate cytokine level elevation. We found obvious tumor shrinkage lasting for more than 2 years by tumor imaging and long-term persistence of TCR-T cells in one patient. In conclusion, NY-ESO-1-specific TCR-T-cell therapy plus vaccination with the pullulan nanogel carrying an LPA containing the NY-ESO-1 epitope without lymphodepletion is feasible and can induce promising long-lasting therapeutic effects in refractory SS (Registration ID: JMA-IIA00346).
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