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:Immunocytokines with target cell-restricted IL-15 activity for treatment of B cell malignancies.
MIC + 构建体结合了 Fc 优化抗体和 IL-15 细胞因子活性的优势,介导更优越的 NK 细胞免疫,并可能减少副作用。
尽管癌症治疗取得了进展,例如通过CD20抗体利妥昔单抗,但仍有迫切的医疗需求来优化此类抗体诱导抗体依赖性细胞毒性(ADCC)的能力,而ADCC决定了治疗效果。细胞因子IL-15刺激NK细胞的增殖、活化和溶细胞能力,但由于半衰期短、在肿瘤部位积累差以及非特异性免疫激活导致的严重毒性,其广泛的临床使用受到限制。我们在此报告了修饰的免疫细胞因子,其由Fc优化的CD19和CD20抗体与包含L45E-E46K双突变的IL-15部分融合而成(MIC + 格式)。E46K突变消除了与IL-15R的结合,从而使得通过靶标结合替代生理性trans-presentation成为可能,并因此实现条件性IL-15R刺激,而L45E突变则优化了IL-15R激动活性和可生产性。使用自体和异体B细胞对NK活化、抗白血病反应性和毒性进行的体外分析证实了MIC +构建体的靶标依赖性功能。与Fc优化的CD19和CD20抗体相比,MIC +构建体介导了更优的靶细胞杀伤和NK细胞增殖。使用表达荧光素酶的人NALM-6淋巴瘤细胞、患者急性淋巴细胞白血病(ALL)细胞以及转导了人CD19/CD20的鼠EL-4淋巴瘤细胞作为靶标,并分别以人和鼠NK细胞作为效应细胞的小鼠模型,证实了更优且靶标依赖性的抗白血病活性。总之,MIC +构建体结合了Fc优化抗体和IL-15细胞因子活性的优势,并介导了更优的NK细胞免疫,且可能减少副作用。因此,它们构成了一种有前景的新免疫治疗方法,此处展示用于B细胞恶性肿瘤。
Despite the advances in cancer treatment achieved, for example, by the CD20 antibody rituximab, an urgent medical need remains to optimize the capacity of such antibodies to induce antibody-dependent cellular cytotoxicity (ADCC) that determines therapeutic efficacy. The cytokine IL-15 stimulates proliferation, activation, and cytolytic capacity of NK cells, but broad clinical use is prevented by short half-life, poor accumulation at the tumor site, and severe toxicity due to unspecific immune activation. We here report modified immunocytokines consisting of Fc-optimized CD19 and CD20 antibodies fused to an IL-15 moiety comprising an L45E-E46K double mutation (MIC + format). The E46K mutation abrogated binding to IL-15R , thereby enabling substitution of physiological trans-presentation by target binding and thus conditional IL-15R stimulation, whereas the L45E mutation optimized IL-15R agonism and producibility. In vitro analysis of NK activation, anti-leukemia reactivity, and toxicity using autologous and allogeneic B cells confirmed target-dependent function of MIC + constructs. Compared with Fc-optimized CD19 and CD20 antibodies, MIC + constructs mediated superior target cell killing and NK cell proliferation. Mouse models using luciferase-expressing human NALM-6 lymphoma cells, patient acute lymphoblastic leukemia (ALL) cells, and murine EL-4 lymphoma cells transduced with human CD19/CD20 as targets and human and murine NK cells as effectors, respectively, confirmed superior and target-dependent anti-leukemic activity. In summary, MIC + constructs combine the benefits of Fc-optimized antibodies and IL-15 cytokine activity and mediate superior NK cell immunity with potentially reduced side effects. They thus constitute a promising new immunotherapeutic approach shown here for B cell malignancies.
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