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:The PD-1- and LAG-3-targeting bispecific molecule tebotelimab in solid tumors and hematologic cancers: a phase 1 trial.
The PD-1- and LAG-3-targeting bispecific molecule tebotelimab in solid tumors and hematologic cancers: a phase 1 trial.
主要终点为 tebotelimab 单药给药(n = 269)或与抗 HER2 抗体 margetuximab 联合给药(n = 84)时的安全性和最大耐受剂量。
Tebotelimab是一种同时阻断PD-1和LAG-3的双特异性PD-1/LAG-3 DART分子。本研究在一项I期剂量递增及队列扩展临床试验中,评估其对既往治疗后进展的实体瘤或血液系统恶性肿瘤患者的安全性和临床活性。主要终点为单药使用(n=269)或联合抗HER2抗体margetuximab(n=84)时的安全性及最大耐受剂量;次要终点包括抗肿瘤活性。接受tebotelimab单药治疗的晚期癌症患者中,68%(184/269)出现治疗相关不良事件(TRAEs),其中22%为3级;未确定最大耐受剂量,推荐II期剂量为每2周600毫克。剂量递增队列中可评价疗效的患者有34%(59/172)出现肿瘤缩小;多种实体瘤类型均观察到客观应答,包括抗PD-1耐药疾病,以及LAG-3阳性的非霍奇金淋巴瘤(包括CAR-T耐药病例)。为增强潜在抗肿瘤应答,研究进一步测试margetuximab联合tebotelimab。接受该联合方案的HER2阳性肿瘤患者中,74%(62/84)出现TRAEs,其中17%为3级;推荐II期剂量为每3周600毫克。患者确认客观缓解率为19%(14/72),包括通常对抗HER2/抗PD-1联合疗法无应答的患者。临床试验注册号:NCT03219268。
Tebotelimab, a bispecific PD-1 LAG-3 DART molecule that blocks both PD-1 and LAG-3, was investigated for clinical safety and activity in a phase 1 dose-escalation and cohort-expansion clinical trial in patients with solid tumors or hematologic malignancies and disease progression on previous treatment. Primary endpoints were safety and maximum tolerated dose of tebotelimab when administered as a single agent (n = 269) or in combination with the anti-HER2 antibody margetuximab (n = 84). Secondary endpoints included anti-tumor activity. In patients with advanced cancer treated with tebotelimab monotherapy, 68% (184/269) experienced treatment-related adverse events (TRAEs; 22% were grade 3). No maximum tolerated dose was defined; the recommended phase 2 dose (RP2D) was 600 mg once every 2 weeks. There were tumor decreases in 34% (59/172) of response-evaluable patients in the dose-escalation cohorts, with objective responses in multiple solid tumor types, including PD-1-refractory disease, and in LAG-3 + non-Hodgkin lymphomas, including CAR-T refractory disease. To enhance potential anti-tumor responses, we tested margetuximab plus tebotelimab. In patients with HER2 + tumors treated with tebotelimab plus margetuximab, 74% (62/84) had TRAEs (17% were grade 3). The RP2D was 600 mg once every 3 weeks. The confirmed objective response rate in these patients was 19% (14/72), including responses in patients typically not responsive to anti-HER2/anti-PD-1 combination therapy. ClinicalTrials.gov identifier: NCT03219268 .
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