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:Secretion of 4-1BB Ligand Crosslinked to PD-1 Checkpoint Inhibitor Potentiates Chimeric Antigen Receptor T Cell Solid Tumor Efficacy.
嵌合抗原受体(CAR)T 细胞疗法已改变血液系统恶性肿瘤的治疗,但由于在肿瘤微环境中缺乏持久性和功能,在实体瘤中尚未取得类似的成功。
嵌合抗原受体(CAR)T细胞疗法已改变血液系统恶性肿瘤的治疗,但由于CAR-T细胞在肿瘤微环境中的持续存留和功能不足,其在实体瘤中尚未取得类似成功。我们此前报告,在一种工程化实体瘤模型中,通过CAR-T细胞分泌抗PD-1单链可变片段(scFv)增强了CAR-T细胞抗肿瘤疗效、扩增和活力。此后,我们进一步改进该平台,构建了性能更优的细胞产品:CAR-T细胞分泌与抗PD-1 scFv融合的单链三聚体4-1BB配体(PD1-41BBL)。4-1BB信号可促进细胞毒性T淋巴细胞增殖和存活,但临床上采用激动性抗体靶向4-1BB,受到抗肿瘤活性低、毒性高的限制。采用4-1BB胞内结构域提供共刺激信号的CAR-T细胞,与采用CD28胞内结构域共刺激的CAR-T细胞相比,抗肿瘤应答较温和但持续存留时间更长。据我们所知,本研究首次对CD28共刺激型CAR-T细胞进行工程化改造,使其分泌包含可溶性三聚体4-1BB配体的融合蛋白。体内外实验显示,与未额外接受4-1BB:4-1BBL共刺激的CAR-T细胞相比,CAR19.PD1-41BBL T细胞抑制性受体上调减少、持续存留和增殖增强,且保持较低分化的记忆状态。相应地,CAR19.PD1-41BBL T细胞治疗的小鼠肿瘤生长控制显著改善,总生存期延长。在以CD19为模型抗原取得临床前成功后,我们制备了靶向间皮素的CAR-T细胞,并证实分泌PD1-41BBL的CAR-T细胞对实体瘤的疗效增强。
Chimeric antigen receptor (CAR) T cell therapy has transformed the treatment of hematological malignancies but has yet to achieve similar success in solid tumors due to a lack of persistence and function in the tumor microenvironment. We previously reported the augmentation of CAR T cell therapy in an engineered solid tumor model through the secretion of anti-PD-1 single-chain fragment variable region (scFv), as shown by enhanced CAR T cell antitumor efficacy, expansion, and vitality. We have since improved the platform to create a superior cellular product-CAR T cells secreting single-chain trimeric 4-1BB ligand fused to anti-PD-1 scFv ( PD1-41BBL). 4-1BB signaling promotes cytotoxic T lymphocyte proliferation and survival but targeting 4-1BB with agonist antibodies in the clinic has been hindered by low antitumor activity and high toxicity. CAR T cells using 4-1BB endodomain for costimulatory signals have demonstrated milder antitumor response and longer persistence compared to CAR T cells costimulated by CD28 endodomain. We have, for the first time, engineered CD28-costimulated CAR T cells to secrete a fusion protein containing the soluble trimeric 4-1BB ligand. In vitro and in vivo , CAR19. PD1-41BBL T cells exhibited reduced inhibitory receptor upregulation, enhanced persistence and proliferation, and a less differentiated memory status compared to CAR T cells without additional 4-1BB:4-1BBL costimulation. Accordingly, CAR19. PD1-41BBL T cell-treated mice displayed significantly improved tumor growth control and overall survival. Spurred on by our preclinical success targeting CD19 as a model antigen, we produced mesothelin-targeting CAR T cells and confirmed the enhanced solid tumor efficacy of PD1-41BBL-secreting CAR T cells.
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