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:Nanobody-derived bispecific CAR-T cell therapy enhances the anti-tumor efficacy of T cell lymphoma treatment.
T 细胞淋巴瘤(TCL)是一组高度异质性的疾病,预后差,5 年总生存率低。
T 细胞淋巴瘤(TCL)是一组高度异质性疾病,预后差,5 年总生存率低,现有治疗方案的疗效也相对有限。针对 T 淋巴细胞开展的单靶点CAR-T(CAR-T)细胞治疗临床研究需要多次、大剂量输注,增加治疗风险和费用,因此优化靶向治疗是改善总体预后的途径之一。双特异性 CAR-T 细胞疗法已显著进展,可用于避免治疗 B 细胞淋巴瘤时的抗原逃逸,但将这一策略用于 TCL 仍需进一步研究。本研究构建羊驼纳米抗体(Nb)噬菌体文库,分别筛选出靶向 CD30 和 CD5、具有高亲和力和高特异性的 Nb。经过多轮筛选,研究构建了双特异性 NbCD30-CD5-CAR T 细胞,并在体外和体内验证其对 TCL 的优异抗肿瘤效果。与单靶点 CAR-T 细胞及基于双特异性单链可变片段(scFv)的 CAR-T 细胞相比,Nb 衍生的双特异性 CAR-T 细胞显著提高了 TCL 治疗的抗肿瘤疗效。由于 Nb 体积更小、免疫原性更低,基于 Nb 的双特异性 CAR-T 细胞的协同效应可能改善其未来临床应用的安全性和疗效。
T cell lymphoma (TCL) is a highly heterogeneous group of diseases with a poor prognosis and low 5-year overall survival rate. The current therapeutic regimens have relatively low efficacy rates. Clinical studies of single-target chimeric antigen receptor T cell (CAR-T cell) therapy in T lymphocytes require large and multiple infusions, increasing the risks and cost of treatment; therefore, optimizing targeted therapy is a way to improve overall prognosis. Despite significant advances in bispecific CAR-T cell therapy to avoid antigen escape in treatment of B cell lymphoma, applying this strategy to TCL requires further investigation. Here, we constructed an alpaca nanobody (Nb) phage library and generated high-affinity and -specificity Nbs targeting CD30 and CD5, respectively. Based on multiple rounds of screening, bispecific NbCD30-CD5-CAR T cells were constructed, and their superior anti-tumor effect against TCL was validated in vitro and in vivo . Our findings demonstrated that Nb-derived bispecific CAR-T cells significantly improved anti-tumor efficacy in TCL treatment compared with single-target CAR-T cells and bispecific single chain variable fragment (scFv)-derived CAR-T cells. Because Nbs are smaller and less immunogenic, the synergistic effect of Nb-based bispecific CAR-T cells may improve their safety and efficacy in future clinical applications.
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