抗 CD22/CD19 CAR-T 细胞疗法 CART2219.1 在成人和儿童复发/难治性 B-ALL 中的 I/II 期试验
A Phase I/II Trial of Anti-CD22/CD19 CAR-T Cell Therapy, CART2219.1, in Adult and Pediatric Relapsed/Refractory B-ALL.
在一项多中心I/II期试验中,所有患者(n=11;7名儿童,4名成人)在第28天均达到完全缓解(91%为微小残留病阴性)。
英文原题:Epitope-engineered human hematopoietic stem cells are shielded from CD123-targeted immunotherapy.
使用单克隆抗体(mAb)、抗体药物偶联物(ADC)、T细胞衔接器(TCE)或嵌合抗原受体(CAR)细胞靶向清除转化或失调的细胞,对血液系统疾病非常有效。
使用单克隆抗体(mAb)、抗体药物偶联物(ADC)、T细胞衔接器(TCE)或嵌合抗原受体(CAR)细胞靶向清除转化或其他失调的细胞,对血液系统疾病非常有效。与B细胞恶性肿瘤取得的突破性进展不同,髓系恶性肿瘤亟需找到合适的抗原。CD123,即白细胞介素-3(IL-3)受体α链,在包括急性髓系白血病(AML)在内的多种血液系统恶性肿瘤中高表达。然而,健康造血干/祖细胞(HSPC)上共享的CD123表达带来了骨髓毒性的风险。我们证明,表位工程改造的HSPC能够免受CD123靶向免疫治疗的攻击,但仍保持功能,而CD123缺陷的HSPC则表现出竞争劣势。移植基因组编辑的HSPC可以在重建全功能造血系统的同时,实现肿瘤选择性靶向免疫治疗。我们设想,该方法可广泛适用于其他靶点和细胞,可使此前无法成药的靶点变得可用于免疫治疗,并将允许移植后继续治疗,例如治疗微小残留病(MRD)。
Targeted eradication of transformed or otherwise dysregulated cells using monoclonal antibodies (mAb), antibody-drug conjugates (ADC), T cell engagers (TCE), or chimeric antigen receptor (CAR) cells is very effective for hematologic diseases. Unlike the breakthrough progress achieved for B cell malignancies, there is a pressing need to find suitable antigens for myeloid malignancies. CD123, the interleukin-3 (IL-3) receptor alpha-chain, is highly expressed in various hematological malignancies, including acute myeloid leukemia (AML). However, shared CD123 expression on healthy hematopoietic stem and progenitor cells (HSPCs) bears the risk for myelotoxicity. We demonstrate that epitope-engineered HSPCs were shielded from CD123-targeted immunotherapy but remained functional, while CD123-deficient HSPCs displayed a competitive disadvantage. Transplantation of genome-edited HSPCs could enable tumor-selective targeted immunotherapy while rebuilding a fully functional hematopoietic system. We envision that this approach is broadly applicable to other targets and cells, could render hitherto undruggable targets accessible to immunotherapy, and will allow continued posttransplant therapy, for instance, to treat minimal residual disease (MRD).
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