CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:RUNX-3-expressing CAR T cells targeting glypican-3 in patients with heavily pretreated advanced hepatocellular carcinoma: a phase I trial.
RUNX-3-expressing CAR T cells targeting glypican-3 in patients with heavily pretreated advanced hepatocellular carcinoma: a phase I trial.
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目前的初步 I 期数据显示,CT017 对晚期 HCC 患者具有可控的安全性特征和有前景的抗肿瘤活性。
Glypican-3(GPC3)是特征明确的肝细胞癌(HCC)相关抗原,也是有前景的 HCC 治疗靶点。CT017 CAR-T 细胞经工程化改造,可共同表达 CAR-GPC3 和 runt 相关转录因子 3(RUNX3);RUNX3 可促进 CD8⁺ T 细胞浸润癌症微环境。
这项单中心、单臂、开放标签 I 期临床研究于 2019 年 8 月至 2020 年 12 月入组既往接受多线治疗的 GPC3 阳性 HCC 患者(NCT03980288)。患者接受 250 × 10⁶ 个 CT017 CAR-T 细胞。主要目标是评估这一首次人体治疗产品的安全性和耐受性。
6 例患者接受了 7 次输注(其中 1 例患者输注 2 次),剂量均为 250 × 10⁶ 个细胞。首次输注时,3 例接受 CT017 单药治疗,3 例接受 CT017 联合酪氨酸激酶抑制剂(TKI)治疗;另有 1 例患者在 CT017 单药治疗后,于第二次输注时接受 CT017-TKI 联合治疗。所有患者均出现细胞因子释放综合征(CRS),其中 50%(3/6)为 2 级,50%(3/6)为 3 级,所有事件经治疗后均消退。未观察到免疫效应细胞相关神经毒性综合征。由于研究者出于安全性考虑,本研究未进行剂量递增。6 例可评估患者中,1 例达到部分缓解,2 例病情稳定;客观缓解率为 16.7%,疾病控制率为 50%,中位无进展生存期为 3.5 个月,中位疾病控制持续时间为 3.2 个月,中位总生存期(OS)为 7.9 个月;中位随访时间为 7.87 个月。CT017 输注后最长 OS 为 18.2 个月。解读:目前初步 I 期数据显示,CT017 治疗晚期 HCC 的安全性可控,并具有有前景的抗肿瘤活性。仍需在高质量临床试验中确认这些结果。经费来源:本研究由 CARsgen Therapeutics Co., Ltd. 资助。
Glypican-3 (GPC3) is a well-characterized hepatocellular carcinoma (HCC)-associated antigen and a promising target for HCC treatment. CT017 CAR T cells were engineered to co-express CAR-GPC3 and runt-related transcription factor 3 (RUNX3), which triggers CD8 + T-cell infiltration into the cancer microenvironment.
This single-center, single-arm, open-label, phase I clinical study enrolled heavily pretreated patients with GPC3-positive HCC between August 2019 and December 2020 (NCT03980288). Patients were treated with CT017 CAR T cells at a dose of 250 10 6 cells. The primary objective was to assess the safety and tolerability of this first-in-human product.
Six patients received 7 infusions (one patient received 2 infusions) at the 250 10 6 cells dose. Three patients received CT017 monotherapy, and three patients received CT017-tyrosine kinase inhibitor (TKI) combination therapy at the first infusion. One patient received CT017-TKI combination therapy at the second infusion after CT017 monotherapy. All patients experienced cytokine release syndrome (CRS), with 50% (3/6) at Grade 2, 50% (3/6) at Grade 3, and all events resolved after treatment. No immune effector cell-associated neurotoxicity syndrome was observed. Dose escalation was not performed due to the investigator's decision regarding safety. Of six evaluable patients, one achieved partial response and two had stable disease for a 16.7% objective response rate, 50% disease control rate, 3.5-month median progression-free survival, 3.2-month median duration of disease control, and 7.9-month median overall survival (OS) with 7.87-month median follow-up. The longest OS was 18.2 months after CT017 infusion. INTERPRETATION: Current preliminary phase I data showed a manageable safety profile and promising antitumor activities of CT017 for patients with advanced HCC. These results need to be confirmed in a robust clinical trial. FUNDING: This study was funded by CARsgen Therapeutics Co., Ltd.
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