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:Homology-independent targeted insertion (HITI) enables guided CAR knock-in and efficient clinical scale CAR-T cell manufacturing.
我们的工作提供了一种利用纳米质粒DNA将CAR引导插入原代人T细胞的新平台,并具有提高CAR-T细胞疗法可及性的潜力。
嵌合抗原受体(CAR)T细胞现已成为部分B细胞和浆细胞恶性肿瘤患者的标准治疗(SOC),并可能改变实体瘤的治疗格局。然而,CAR-T细胞的可及性不足以满足临床需求,部分原因是临床级病毒的生产成本高、周期长。非病毒定点CAR整合可通过CRISPR/Cas9和双链DNA(dsDNA)或单链DNA(ssDNA)经同源定向修复(HDR)实现,但该方法的产量在临床应用上一直受限(dsDNA),或在早期临床试验之外获得足以满足生产需求的高产量受限(ssDNA)。
我们应用同源非依赖性靶向插入(HITI)或使用CRISPR/Cas9和纳米质粒DNA的HDR,将抗GD2 CAR插入T细胞受体α恒定区(TRAC)位点,并在我们的系统中比较了两种靶向插入策略。接下来,我们优化了HITI后CRISPR富集(CEMENT),将其无缝整合到14天流程中,并将我们的敲入与病毒转导的抗GD2 CAR-T细胞进行了比较。最后,我们探索了我们的基因组工程方法的脱靶基因组毒性。
在此,我们证明利用通过HITI递送的纳米质粒DNA进行定点CAR整合,可获得高细胞产量和高度功能化的细胞。CEMENT将CAR T细胞富集至约80%纯度,产生5.5 10 8 -3.6 10 9 CAR + T细胞的治疗相关剂量范围。CRISPR敲入CAR-T细胞在功能上与病毒转导的抗GD2 CAR-T细胞相当,且未显示任何脱靶基因组毒性的证据。
BACKGROUND: Chimeric Antigen Receptor (CAR) T cells are now standard of care (SOC) for some patients with B cell and plasma cell malignancies and could disrupt the therapeutic landscape of solid tumors. However, access to CAR-T cells is not adequate to meet clinical needs, in part due to high cost and long lead times for manufacturing clinical grade virus. Non-viral site directed CAR integration can be accomplished using CRISPR/Cas9 and double-stranded DNA (dsDNA) or single-stranded DNA (ssDNA) via homology-directed repair (HDR), however yields with this approach have been limiting for clinical application (dsDNA) or access to large yields sufficient to meet the manufacturing demands outside early phase clinical trials is limited (ssDNA). METHODS: We applied homology-independent targeted insertion (HITI) or HDR using CRISPR/Cas9 and nanoplasmid DNA to insert an anti-GD2 CAR into the T cell receptor alpha constant (TRAC) locus and compared both targeted insertion strategies in our system. Next, we optimized post-HITI CRISPR EnrichMENT (CEMENT) to seamlessly integrate it into a 14-day process and compared our knock-in with viral transduced anti-GD2 CAR-T cells. Finally, we explored the off-target genomic toxicity of our genomic engineering approach. RESULTS: Here, we show that site directed CAR integration utilizing nanoplasmid DNA delivered via HITI provides high cell yields and highly functional cells. CEMENT enriched CAR T cells to approximately 80% purity, resulting in therapeutically relevant dose ranges of 5.5 10 8 -3.6 10 9 CAR + T cells. CRISPR knock-in CAR-T cells were functionally comparable with viral transduced anti-GD2 CAR-T cells and did not show any evidence of off-target genomic toxicity. CONCLUSIONS: Our work provides a novel platform to perform guided CAR insertion into primary human T-cells using nanoplasmid DNA and holds the potential to increase access to CAR-T cell therapies.
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