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:Dual targeting of CD19 and CD22 against B-ALL using a novel high-sensitivity aCD22 CAR.
识别 CD19 的 CAR T 细胞可有效治疗复发/难治性 B-ALL 和 DLBCL。
识别CD19的CAR-T细胞可有效治疗复发和难治性B-ALL及弥漫大B细胞淋巴瘤(DLBCL),但CD19丢失是常见复发原因。同时靶向第二种抗原CD22可能减少抗原逃逸,但存在挑战:CD22密度约比CD19低10倍,且其结构较大,可能妨碍免疫突触形成。目前尚未充分研究最佳CD22 CAR的特征。我们制备了12种不同CD22抗体,并测试其衍生CAR,最终鉴定出基于新型抗体9A8的CAR;该CAR对低密度CD22敏感,且无持续性信号。我们未发现CD22免疫球蛋白结构域3–6中结合亲和力或表位与膜距离和CAR-T功能之间存在相关性。CD19/CD22 CAR-T细胞共同靶向的最佳策略尚未明确。共同给予CD19和CD22 CAR-T细胞成本较高;构建同时靶向CD19和CD22的单一CAR也具有挑战。既往曾采用双顺反子载体实现两个CAR共表达。本文通过共同转导9A8-41BB和CAT-41BB(既往报道的CD19 CAR,obe-cel),制备双CAR-T细胞产品。CAT/9A8 CAR-T细胞在体外清除了单阳性和双阳性靶细胞,并在体内清除了CD19阴性肿瘤。CAT/9A8 CAR-T目前正在I期临床研究中评估(NCT02443831)。
CAR T cells recognizing CD19 effectively treat relapsed and refractory B-ALL and DLBCL. However, CD19 loss is a frequent cause of relapse. Simultaneously targeting a second antigen, CD22, may decrease antigen escape, but is challenging: its density is approximately 10-fold less than CD19, and its large structure may hamper immune synapse formation. The characteristics of the optimal CD22 CAR are underexplored. We generated 12 distinct CD22 antibodies and tested CARs derived from them to identify a CAR based on the novel 9A8 antibody, which was sensitive to low CD22 density and lacked tonic signaling. We found no correlation between affinity or membrane proximity of recognition epitope within Ig domains 3-6 of CD22 with CART function. The optimal strategy for CD19/CD22 CART co-targeting is undetermined. Co-administration of CD19 and CD22 CARs is costly; single CARs targeting CD19 and CD22 are challenging to construct. The co-expression of two CARs has previously been achieved using bicistronic vectors. Here, we generated a dual CART product by co-transduction with 9A8-41BB and CAT-41BB (obe-cel), the previously described CD19 CAR. CAT/9A8 CART eliminated single- and double-positive target cells in vitro and eliminated CD19 - tumors in vivo. CAT/9A8 CART is being tested in a phase I clinical study (NCT02443831).
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