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:Targeting high-risk multiple myeloma genotypes with optimized anti-CD70 CAR-T cells.
这些发现支持了在骨髓瘤中使用优化CAR-T靶向CD70的前景,以及该方法未来的临床转化。
尽管BCMA靶向CAR-T在多发性骨髓瘤中取得了成功,但具有高危细胞遗传学特征的患者仍然复发最快,亟需额外的治疗选择。在此,我们确定CD70——在其他癌症中被广泛认为是有利的免疫治疗靶点——是高危骨髓瘤肿瘤中特异性上调的细胞表面抗原。我们采用结构引导设计,确定了一种基于CD27的抗CD70 CAR-T设计,其表现优于所有测试的基于scFv的CAR,使体内CAR-T扩增提高>80倍。通过机器学习进行的表观遗传分析预测了驱动高危骨髓瘤中CD70上调的关键转录因子和转录网络。针对CD70或BCMA的双靶向CAR-T展示了一种避免抗原逃逸介导耐药的潜在策略。总之,这些发现支持了在骨髓瘤中使用优化CAR-T靶向CD70的前景,以及该方法未来的临床转化。
Despite the success of BCMA-targeting CAR-Ts in multiple myeloma, patients with high-risk cytogenetic features still relapse most quickly and are in urgent need of additional therapeutic options. Here, we identify CD70, widely recognized as a favorable immunotherapy target in other cancers, as a specifically upregulated cell surface antigen in high risk myeloma tumors. We use a structure-guided design to define a CD27-based anti-CD70 CAR-T design that outperforms all tested scFv-based CARs, leading to >80-fold improved CAR-T expansion in vivo. Epigenetic analysis via machine learning predicts key transcription factors and transcriptional networks driving CD70 upregulation in high risk myeloma. Dual-targeting CAR-Ts against either CD70 or BCMA demonstrate a potential strategy to avoid antigen escape-mediated resistance. Together, these findings support the promise of targeting CD70 with optimized CAR-Ts in myeloma as well as future clinical translation of this approach.
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