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:Engineering allorejection-resistant CAR-NKT cells from hematopoietic stem cells for off-the-shelf cancer immunotherapy.
这些临床前研究共同凸显了 U CAR-NKT 细胞产品的可行性及显著的治疗潜力,并为其转化与临床开发奠定了基础。
目前获FDA批准的嵌合抗原受体(CAR)工程化T(CAR-T)细胞疗法为自体疗法,其临床应用受到制约,面临生产复杂、成本升高和患者选择受限等显著挑战。因此,对现货型通用细胞疗法的需求日益增加。本研究通过在造血干细胞(HSC)中整合不变型自然杀伤T(iNKT)细胞TCR工程化和HLA基因编辑,并结合体外无饲养层的HSC分化培养,制备了通用CAR工程化NKT(U CAR-NKT)细胞。U CAR-NKT细胞产量高、纯度高且制备稳健,并呈现稳定的HLA缺失表型,使其能够抵抗宿主细胞介导的同种异体排斥。这些U CAR-NKT细胞通过多种肿瘤靶向机制,在体内外均对血液肿瘤和实体瘤表现出强效抗肿瘤作用。它们还可选择性清除免疫抑制性肿瘤相关巨噬细胞和髓源性抑制细胞,从而改变肿瘤微环境。此外,U CAR-NKT细胞具有良好安全性,移植物抗宿主病和细胞因子释放综合征风险较低。总体而言,这些临床前研究支持U CAR-NKT细胞产品的可行性和巨大治疗潜力,并为其转化和临床开发奠定基础。
The clinical potential of current FDA-approved chimeric antigen receptor (CAR)-engineered T (CAR-T) cell therapy is encumbered by its autologous nature, which presents notable challenges related to manufacturing complexities, heightened costs, and limitations in patient selection. Therefore, there is a growing demand for off-the-shelf universal cell therapies. In this study, we have generated universal CAR-engineered NKT ( U CAR-NKT) cells by integrating iNKT TCR engineering and HLA gene editing on hematopoietic stem cells (HSCs), along with an ex vivo, feeder-free HSC differentiation culture. The U CAR-NKT cells are produced with high yield, purity, and robustness, and they display a stable HLA-ablated phenotype that enables resistance to host cell-mediated allorejection. These U CAR-NKT cells exhibit potent antitumor efficacy to blood cancers and solid tumors, both in vitro and in vivo, employing a multifaceted array of tumor-targeting mechanisms. These cells are further capable of altering the tumor microenvironment by selectively depleting immunosuppressive tumor-associated macrophages and myeloid-derived suppressor cells. In addition, U CAR-NKT cells demonstrate a favorable safety profile with low risks of graft-versus-host disease and cytokine release syndrome. Collectively, these preclinical studies underscore the feasibility and significant therapeutic potential of U CAR-NKT cell products and lay a foundation for their translational and clinical development.
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