CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:CD22 CAR T cells demonstrate high response rates and safety in pediatric and adult B-ALL: Phase 1b results.
CD22 CAR T cells demonstrate high response rates and safety in pediatric and adult B-ALL: Phase 1b results.
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靶向CD22的嵌合抗原受体(CAR)T细胞(CD22-CAR)为CD19靶向治疗后进展的CD22+恶性肿瘤患者提供了一种治疗选择。采用现场、自动化、闭环式生产,我们开展了平行1b期临床试验,在既往接受过大量治疗、复发/难治性(r/r)B-ALL的儿童和成人中研究一种含41BB共刺激结构域的人源化CD22-CAR。19例入组患者中,18例成功完成CD22-CAR生产,16例接受了输注。高级别(3-4级)细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性综合征(ICANS)各仅发生于1例患者;然而,3例患者发生了免疫效应细胞相关噬血细胞性淋巴组织细胞增多症样综合征(IEC-HS)。16例患者中有12例(75%)达到CR,总体MRD阴性CR率为56%。缓解持续时间总体上有限(中位77天),并且在复发时4/12(33%)可获得样本中CD22表达下调。
总之,我们证明CD22-CAR-T 细胞的闭环式生产是可行的,并且在儿童和成人r/r B-ALL中与良好的安全性特征和高CR率相关,而该人群的CD22-CAR报道有限。
Chimeric antigen receptor (CAR) T cells targeting CD22 (CD22-CAR) provide a therapeutic option for patients with CD22 + malignancies with progression after CD19-directed therapies. Using on-site, automated, closed-loop manufacturing, we conducted parallel Phase 1b clinical trials investigating a humanized CD22-CAR with 41BB costimulatory domain in children and adults with heavily treated, relapsed/refractory (r/r) B-ALL. Of 19 patients enrolled, 18 had successful CD22-CAR manufacturing, and 16 patients were infused.
High grade (3-4) cytokine release syndrome (CRS) and immune effector-cell-associated neurotoxicity syndrome (ICANS) each occurred in only one patient; however, three patients experienced immune-effector-cell-associated hemophagocytic lymphohistiocytosis-like syndrome (IEC-HS). Twelve of 16 patients (75%) achieved CR with an overall 56% MRD-negative CR rate.
Duration of response was overall limited (median 77 days), and CD22 expression was downregulated in 4/12 (33%) available samples at relapse. In summary, we demonstrate that closed-loop manufacturing of CD22-CAR T cells is feasible and is associated with a favorable safety profile and high CR rates in pediatric and adult r/r B-ALL, a cohort with limited CD22-CAR reporting.
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