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:Immune determinants of CAR-T cell expansion in solid tumor patients receiving GD2 CAR-T cell therapy.
我们的数据揭示了CAR-T生物学的介质和扩增的相关因素,这些可用于推进实体瘤患者的免疫疗法。
CAR-T 细胞在液体肿瘤中具有显著疗效,但在实体瘤中应答有限。我们开展了一项GD2 CAR-T(GD2-CAR.OX40.28.z.iC9)的I期试验(NCT02107963),证明在骨肉瘤和神经母细胞瘤儿童及年轻成人中给药可行且安全。由于CAR-T疗效需要充分的CAR-T扩增,患者按各剂量水平分为良好扩增者和不良扩增者。通过多维蛋白质组学、转录组学和表观遗传学分析对患者样本进行评估。T细胞评估发现,治疗前单采物中的naive T细胞与良好扩增相关,而CAR-T产品中的耗竭T细胞与不良扩增相关。髓系细胞评估发现,治疗前单采物中的CXCR3 + 单核细胞与良好扩增相关。对治疗后样本的纵向分析发现,随着CAR-T数量减少,所有组中CXCR3 - 经典单核细胞均增加。总之,我们的数据揭示了CAR-T生物学介质及扩增相关因素,可用于推进实体瘤患者的免疫治疗。
Chimeric antigen receptor T cells (CAR-Ts) have remarkable efficacy in liquid tumors, but limited responses in solid tumors. We conducted a Phase I trial (NCT02107963) of GD2 CAR-Ts (GD2-CAR.OX40.28.z.iC9), demonstrating feasibility and safety of administration in children and young adults with osteosarcoma and neuroblastoma. Since CAR-T efficacy requires adequate CAR-T expansion, patients were grouped into good or poor expanders across dose levels. Patient samples were evaluated by multi-dimensional proteomic, transcriptomic, and epigenetic analyses. T cell assessments identified naive T cells in pre-treatment apheresis associated with good expansion, and exhausted T cells in CAR-T products with poor expansion. Myeloid cell assessment identified CXCR3 + monocytes in pre-treatment apheresis associated with good expansion. Longitudinal analysis of post-treatment samples identified increased CXCR3 - classical monocytes in all groups as CAR-T numbers waned. Together, our data uncover mediators of CAR-T biology and correlates of expansion that could be utilized to advance immunotherapies for solid tumor patients.
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