不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:KLRG1 Cell Depletion as a Novel Therapeutic Strategy in Patients with Mature T-Cell Lymphoma Subtypes.
KLRG1 Cell Depletion as a Novel Therapeutic Strategy in Patients with Mature T-Cell Lymphoma Subtypes.
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我们的研究结果提示,将治疗性抗体与 PI3Ki 联合的更广泛治疗策略对成熟 T 细胞和 NK 细胞肿瘤患者具有潜在获益。
为成熟T细胞和NK细胞肿瘤亚型患者开发新的治疗策略。 实验设计:使用原代样本、细胞系、患者来源异种移植模型,以及市售和专有抗KLRG1抗体进行筛选、靶点和功能验证。
我们发现,部分结外NK/T细胞淋巴瘤(ENKTCL)、T幼淋巴细胞白血病(T-PLL)和γ/δ T细胞淋巴瘤(G/D TCL)患者的肿瘤细胞表面KLRG1高表达。T细胞和NK大颗粒淋巴细胞白血病(T-LGLL及NK-LGLL)患者来源的多数CD8+/CD57+或CD3−/CD56+白血病细胞分别表达表面KLRG1。为用于小鼠体内实验而优化的人源化去岩藻糖基抗KLRG1单克隆抗体mAb208,通过抗体依赖性细胞介导的细胞毒作用(ADCC)、吞噬作用(ADCP)和补体依赖性细胞毒作用(CDC),而非细胞凋亡,清除KLRG1+ TCL细胞。mAb208在体外可诱导患者来源T-LGLL CD8+/CD57+细胞发生ADCC和ADCP。该抗体还能诱导健康供者部分KLRG1+ NK、CD4+、CD8+效应记忆(Tem)及TemRA细胞发生ADCC,同时保留KLRG1−初始T细胞和CD8+中央记忆(Tcm)细胞。使用mAb208或抗CD47抗体单独或联合PI3K-δ抑制剂duvelisib治疗细胞系及TCL患者来源异种移植模型,可延长生存期;体内耗竭巨噬细胞则会削弱mAb208疗效。
结果提示,治疗性抗体联合PI3K抑制剂可能为成熟T细胞和NK细胞肿瘤患者提供更广泛的治疗策略。相关评论见Varma和Diefenbach,2300页。
Develop a novel therapeutic strategy for patients with subtypes of mature T-cell and NK-cell neoplasms. EXPERIMENTAL DESIGN: Primary specimens, cell lines, patient-derived xenograft models, commercially available, and proprietary anti-KLRG1 antibodies were used for screening, target, and functional validation.
Here we demonstrate that surface KLRG1 is highly expressed on tumor cells in subsets of patients with extranodal NK/T-cell lymphoma (ENKTCL), T-prolymphocytic leukemia (T-PLL), and gamma/delta T-cell lymphoma (G/D TCL). The majority of the CD8+/CD57+ or CD3-/CD56+ leukemic cells derived from patients with T- and NK-large granular lymphocytic leukemia (T-LGLL and NK-LGLL), respectively, expressed surface KLRG1. The humanized afucosylated anti-KLRG1 monoclonal antibody (mAb208) optimized for mouse in vivo use depleted KLRG1+ TCL cells by mechanisms of ADCC, ADCP, and CDC rather than apoptosis. mAb208 induced ADCC and ADCP of T-LGLL patient-derived CD8+/CD57+ cells ex vivo. mAb208 effected ADCC of subsets of healthy donor-derived KLRG1+ NK, CD4+, CD8+ Tem, and TemRA cells while sparing KLRG1- na ve and CD8+ Tcm cells. Treatment of cell line and TCL patient-derived xenografts with mAb208 or anti-CD47 mAb alone and in combination with the PI3K- / inhibitor duvelisib extended survival. The depletion of macrophages in vivo antagonized mAb208 efficacy.
Our findings suggest the potential benefit of a broader treatment strategy combining therapeutic antibodies with PI3Ki for the treatment of patients with mature T-cell and NK-cell neoplasms. See related commentary by Varma and Diefenbach, p. 2300.
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