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.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:TRBC1-targeting antibody-drug conjugates for the treatment of T cell cancers.
TRBC1-targeting antibody-drug conjugates for the treatment of T cell cancers.
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抗体和嵌合抗原受体(CAR)T细胞介导的靶向治疗改善了实体瘤和血液系统恶性肿瘤患者的生存1-9。患有T细胞白血病和淋巴瘤(统称为T细胞癌症)的成人存活期短10,11,且缺乏此类靶向治疗。
因此,T细胞癌症尤其需要开发CAR-T 细胞和抗体以改善患者预后。临床前研究表明,靶向T细胞受体β链恒定区1(TRBC1)可杀死癌性T细胞,同时保留足够的健康T细胞以维持免疫12,使TRBC1成为治疗T细胞癌症的有吸引力的靶点。
然而,抗TRBC1 CAR-T 细胞的首次人体临床试验报告了低缓解率和抗TRBC1 CAR-T 细胞的不明原因丢失13,14。
在此,我们证明CAR-T 细胞因被患者正常T细胞杀死而丢失,从而降低其疗效。为规避这一问题,我们开发了一种抗体-药物偶联物,可在体外杀死TRBC1+癌细胞,并在小鼠模型中治愈人类T细胞癌症。抗TRBC1抗体-药物偶联物可能为TRBC1靶向提供最佳形式,并在T细胞癌症患者中产生优越的缓解。
Antibody and chimeric antigen receptor (CAR) T cell-mediated targeted therapies have improved survival in patients with solid and haematologic malignancies 1-9 . Adults with T cell leukaemias and lymphomas, collectively called T cell cancers, have short survival 10,11 and lack such targeted therapies.
Thus, T cell cancers particularly warrant the development of CAR T cells and antibodies to improve patient outcomes. Preclinical studies showed that targeting T cell receptor -chain constant region 1 (TRBC1) can kill cancerous T cells while preserving sufficient healthy T cells to maintain immunity 12 , making TRBC1 an attractive target to treat T cell cancers.
However, the first-in-human clinical trial of anti-TRBC1 CAR T cells reported a low response rate and unexplained loss of anti-TRBC1 CAR T cells 13,14 .
Here we demonstrate that CAR T cells are lost due to killing by the patient's normal T cells, reducing their efficacy. To circumvent this issue, we developed an antibody-drug conjugate that could kill TRBC1 + cancer cells in vitro and cure human T cell cancers in mouse models. The anti-TRBC1 antibody-drug conjugate may provide an optimal format for TRBC1 targeting and produce superior responses in patients with T cell cancers.
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