决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:IL7 and IL7 Flt3L co-expressing CAR T cells improve therapeutic efficacy in mouse EGFRvIII heterogeneous glioblastoma.
IL7 and IL7 Flt3L co-expressing CAR T cells improve therapeutic efficacy in mouse EGFRvIII heterogeneous glioblastoma.
在此,我们改造了 CAR-T 细胞,使其在经非淋巴细胞清除性照射预处理的 50% 的 EGFRvIII 阳性和阴性原位肿瘤中表达 IL7 和/或 Flt3L。
胶质母细胞瘤中的CAR-T 细胞疗法面临诸多挑战,包括CAR-T细胞数量不足以及抗原阴性肿瘤细胞逃逸靶向攻击。遗憾的是,评估CAR-T治疗胶质母细胞瘤的临床前研究,通常采用仅表达单一抗原的肿瘤模型、免疫缺陷动物和/或淋巴细胞清除预处理。尽管淋巴细胞清除可增强CAR-T疗效,但也会削弱具有清除肿瘤潜力的内源性免疫系统。本研究对CAR-T细胞进行工程化改造,使其表达IL-7和/或Flt3L,并在非淋巴细胞清除性照射预处理的原位肿瘤中进行研究;肿瘤中EGFRvIII阳性和阴性细胞各占50%。治疗7天后,表达IL-7的CAR-T及同时表达IL-7和Flt3L的CAR-T均增加了肿瘤内CAR-T细胞数量。IL-7与Flt3L共表达可适度增加常规树突状细胞数量,也可增加具有迁移和抗原交叉呈递能力的CD103⁺XCR1⁺细胞群。与传统CAR-T或仅表达Flt3L的CAR-T治疗组9%的生存率相比,IL-7 CAR-T和IL-7/Flt3L CAR-T治疗组总生存率分别提高至67%和50%。我们据此认为,在非淋巴细胞清除性照射预处理的EGFRvIII异质性肿瘤中,表达IL-7的CAR-T可增加CAR-T细胞数量并改善总生存。IL-7 CAR-T或IL-7/Flt3L CAR-T可能为胶质母细胞瘤CAR-T与其他免疫疗法联合治疗提供新机会。
Chimeric antigen receptor (CAR) T cell therapy in glioblastoma faces many challenges including insufficient CAR T cell abundance and antigen-negative tumor cells evading targeting. Unfortunately, preclinical studies evaluating CAR T cells in glioblastoma focus on tumor models that express a single antigen, use immunocompromised animals, and/or pre-treat with lymphodepleting agents. While lymphodepletion enhances CAR T cell efficacy, it diminishes the endogenous immune system that has the potential for tumor eradication. Here, we engineered CAR T cells to express IL7 and/or Flt3L in 50% EGFRvIII-positive and -negative orthotopic tumors pre-conditioned with non-lymphodepleting irradiation. IL7 and IL7 Flt3L CAR T cells increased intratumoral CAR T cell abundance seven days after treatment. IL7 co-expression with Flt3L modestly increased conventional dendritic cells as well as the CD103+XCR1+ population known to have migratory and antigen cross-presenting capabilities. Treatment with IL7 or IL7 Flt3L CAR T cells improved overall survival to 67% and 50%, respectively, compared to 9% survival with conventional or Flt3L CAR T cells. We concluded that CAR T cells modified to express IL7 enhanced CAR T cell abundance and improved overall survival in EGFRvIII heterogeneous tumors pre-conditioned with non-lymphodepleting irradiation. Potentially IL7 or IL7 Flt3L CAR T cells can provide new opportunities to combine CAR T cells with other immunotherapies for the treatment of glioblastoma.
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