RNF43 p.G659fs 通过 PI3K/AKT/mTOR 信号通路和 HLA-E 上调导致 MSI-high 结直肠癌中 NK 细胞功能障碍
RNF43 p.G659fs leads to natural killer cell dysfunction in MSI-high colorectal cancer through PI3K/AKT/mTOR signaling and HLA-E up-regulation.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Phase I non-randomized clinical trial of allogeneic natural killer cells infusion in acute myeloid leukemia patients.
Phase I non-randomized clinical trial of allogeneic natural killer cells infusion in acute myeloid leukemia patients.
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该研究证明了在复发/难治性 AML 患者中过继输注随机健康无关供者 PB-NK 细胞的可行性与安全性,并支持在复发/难治性 AML 患者中继续开展 II 期临床研究。
使用随机选取的健康无关供者制备异基因NK细胞;根据纳入标准选取10例患者,并按NK细胞剂量递增分为两组。患者先接受氟达拉滨联合环磷酰胺淋巴细胞清除预处理,于首次输注前7天给药,随后每隔7天进行一次细胞输注,共输注两次。依据细胞输注引起的生命体征变化,采用不良事件通用术语标准(CTCAE)评估干预安全性。NK细胞嵌合率、肿瘤负荷及复发时间用于评估疗效,并依照CONSORT平台框架进行试点可行性评估。
NK细胞输注过程耐受性良好,未观察到与外周血NK细胞输注相关(可能或很可能相关)的2至5级毒性。4例患者在每次外周血NK细胞输注后发生短暂的1级寒战、头痛、呕吐及骨痛,无需住院。其中一名患者(p01)死于重症急性呼吸综合征。9例可评估患者中,6例(66.6%)病情稳定,3例(33.3%)出现疾病进展。6例疾病稳定患者中,2例(p08和p09)仍存活且病情稳定;3例(p04、p05和p07)在NK细胞输注后9个月转为疾病进展;1例(p03)因失访无法评估。无患者达到完全缓解。
本研究证明,随机选取的健康无关供者外周血NK细胞可过继转移给难治/复发性AML患者,且具有可行性和安全性;研究结果支持继续在复发/难治性AML患者中开展II期临床试验。
The NK cell infusion procedure was well tolerated, and no grade 2-5 toxicities related (possible or probable) to PB-NK cell infusion were observed. Four patients developed grade 1 transient chills, headaches, vomiting, and bone pain following each PB-NK cell infusion that were not required hospitalization. One of these patients (p01) died because of severe acute respiratory syndrome. Of 9 evaluable patients, 6 (66.6%) showed stable disease (SD) and 3 (33.3%) presented progressive disease (PD). Of 6 SD patients, 2 (p08 and p09) remained alive in SD and 3 patients (p04, p05 and p07) converted to PD at 9 months after infusion of NK cells, and 1 (p03) was not evaluable due to follow-up loss. No patient achieved complete remission.
The study demonstrated the feasibility and safety of adoptive transfer of random healthy unrelated donor PB-NK cells in refractory/relapsed AML patients and supports continued study in phase II clinical trials in relapsed/refractory AML patients.
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