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:ICOS and OX40 tandem co-stimulation enhances CAR T-cell cytotoxicity and promotes T-cell persistence phenotype.
我们得出结论,由 ICOS.OX40 串联共刺激激活的抗 ROR1 CAR T 细胞在体外和体内均表现出增强的靶向细胞毒性,并伴有促进 T 细胞持续存在的表型。
CAR-T 细胞疗法已成为复发或难治性恶性肿瘤患者有效且可能具有治愈性的免疫治疗。CD19 CAR-T在血液系统恶性肿瘤中取得了前所未有的疗效,包括经多线治疗的白血病、淋巴瘤和骨髓瘤患者。尽管成果令人鼓舞,仍有约50%–70%的患者无法获得长期缓解,且CAR-T对实体瘤疗效较低。其原因包括缺乏可靶向的肿瘤相关抗原、CAR设计的局限、与肿瘤微环境(TME)的相互作用,以及CAR-T细胞持续时间较短。为此,研究人员开发并测试了抗ROR1单链可变片段CAR构建体,并将CD3与第二代或第三代胞内信号结构域相连,包括4-1BB、CD28/4-1BB、ICOS/4-1BB或ICOS/OX40。经过多轮体外肿瘤细胞刺激后,ROR1.ICOS.OX40细胞仍持续增殖、产生促炎细胞因子,并以更强效力杀伤ROR1阳性细胞系。此外,体内ROR1.ICOS.OX40 T细胞表现出抗淋巴瘤活性、长期中央记忆表型、总生存期改善以及CAR-T细胞长期持续存在的证据。研究认为,采用ICOS/OX40串联共刺激的抗ROR1 CAR-T可增强体内外靶向细胞毒性,并形成有利于T细胞持续存在的表型。
Chimeric Antigen Receptor (CAR) T-cell therapies have emerged as an effective and potentially curative immunotherapy for patients with relapsed or refractory malignancies. Treatment with CD19 CAR T-cells has shown unprecedented results in hematological malignancies, including heavily refractory leukemia, lymphoma, and myeloma cases. Despite these encouraging results, CAR T-cell therapy faces limitations, including the lack of long-term responses in nearly 50-70% of the treated patients and low efficacy in solid tumors. Among other reasons, these restrictions are related to the lack of targetable tumor-associated antigens, limitations on the CAR design and interactions with the tumor microenvironment (TME), as well as short-term CAR T-cell persistence. Because of these reasons, we developed and tested a chimeric antigen receptor (CAR) construct with an anti-ROR1 single-chain variable-fragment cassette connected to CD3 by second and third-generation intracellular signaling domains including 4-1BB, CD28/4-1BB, ICOS/4-1BB or ICOS/OX40. We observed that after several successive tumor-cell in vitro challenges, ROR1.ICOS.OX40 continued to proliferate, produce pro-inflammatory cytokines, and induce cytotoxicity against ROR1 + cell lines in vitro with enhanced potency. Additionally, in vivo ROR1.ICOS.OX40 T-cells showed anti-lymphoma activity, a long-lasting central memory phenotype, improved overall survival, and evidence of long-term CAR T-cell persistence. We conclude that anti-ROR1 CAR T-cells that are activated by ICOS.OX40 tandem co-stimulation show in vitro and in vivo enhanced targeted cytotoxicity associated with a phenotype that promotes T-cell persistence.
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