为肝细胞癌武装 GPC3 CAR-T 细胞:多少才足够,下一步是什么?
Armouring GPC3 CAR T cells for hepatocellular carcinoma: how much is enough and what comes next?
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Messenger RNA electroporated hepatitis B virus (HBV) antigen-specific T cell receptor (TCR) redirected T cell therapy is well-tolerated in patients with recurrent HBV-related hepatocellular carcinoma post-liver transplantation: results from a phase I trial.
Messenger RNA electroporated hepatitis B virus (HBV) antigen-specific T cell receptor (TCR) redirected T cell therapy is well-tolerated in patients with recurrent HBV-related hepatocellular carcinoma post-liver transplantation: results from a phase I trial.
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本研究表明,多次输注 mRNA 电转的 HBV 特异性 TCR-T 细胞在肝移植后 HBV 阳性复发性 HCC 患者中耐受性良好。
肝移植是早期肝细胞癌(HCC)肝硬化患者主要根治方法,但15%至20%病例会复发且预后不良。研究团队已构建针对不同乙肝病毒(HBV)抗原、受不同HLA I类分子限制的TCR库,可将T细胞重定向识别HBV抗原;此前还证实,电转mRNA获得短暂功能的HBV特异性T细胞可体内外清除表达HBV抗原的HCC细胞。本I期临床试验评估肝移植后HCC复发患者接受mRNA电转HBV特异性TCR-T的安全性、耐受性和抗肿瘤活性。
纳入6名肝移植后HBV阳性HCC复发患者,其HLA与靶向HBsAg或HBcAg的TCR匹配(HLA-A*02:01/HBsAg、A*11:01/HBcAg、B*58:01/HBsAg或C*08:01/HBsAg)。主要目标是按NCI CTCAE 4.0评估短效mRNA电转HBV-TCR T细胞的安全性;次要目标按RECIST 1.1评估疗效,治疗结束后随访生存2年。
患者中位年龄35.5岁;中位输注6.5次(4至12次)。治疗相关不良事件为1级发热;未出现CRS或神经毒性。数据截止2020年4月30日时,1人生存,5人死亡。
多次输注mRNA电转HBV特异性TCR-T,对肝移植后HBV阳性HCC复发患者耐受良好。
A total of six patients with HBV-positive recurrent HCC post-liver transplant and HLA-matched to TCR targeting hepatitis B surface antigen (HBsAg) or hepatitis B core antigen (HBcAg) (HLA-A*02:01/HBsAg, HLA-A*11:01/HBcAg, HLA-B*58:01/HBsAg or HLA-C*08:01/HBsAg) were enrolled in this study. The primary objective was to assess the safety of short-lived mRNA electroporated HBV-TCR T cells based on the incidence and severity of the adverse event (AE) graded per National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 4.0. The secondary objective was to determine the effectiveness of HBV-TCR T cells as per RECIST 1.1 criteria. Patients were followed up for survival for 2 years post-end of treatment.
The median age of the six patients was 35.5 years (range: 28-47). The median number of HBV-TCR T cell infusions administered was 6.5 (range: 4-12). The treatment-related AE included grade 1 pyrexia. This study reported no cytokine release syndrome nor neurotoxicity. One patient remained alive and five were deceased at the time of the data cutoff (30 April 2020).
This study has demonstrated that multiple infusions of mRNA electroporated HBV-specific TCR T cells were well-tolerated in patients with HBV-positive recurrent HCC post-liver transplant.
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