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:Preclinical Development of CAR T Cells with Antigen-Inducible IL18 Enforcement to Treat GD2-Positive Solid Cancers.
这些结果为在神经母细胞瘤及其他 GD2 阳性肿瘤的儿童和成人患者中开展 GD2IL18CART 的临床研究铺平了道路(EU CT 2022- 501725-21-00)。
目的:通过细胞因子工程化改造嵌合抗原受体重定向T细胞(CAR-T),是克服经典CAR-T细胞对实体瘤活性有限的一种有前景策略。 实验设计:我们开发了一种研究用药GD2IL18CART,由靶向神经节苷脂GD2的CAR-T细胞组成,并使CAR可诱导表达IL18,以增强其活化应答和在肿瘤微环境中的细胞溶解效应功能。为按肿瘤GD2表达对患者分层,我们建立并验证了在石蜡包埋肿瘤组织中通过免疫荧光检测GD2的方法。 结果:采用慢病毒一体化载体,将带或不带诱导型IL18的GD2特异性CAR导入人T细胞后,所得细胞产品中CAR表达阳性的中央记忆T细胞比例相近。IL18生成严格依赖GD2抗原结合。与不含诱导型IL18的CAR-T细胞相比,GD2IL18CART与GD2阳性肿瘤细胞相互作用后,可释放更多IFN和TNF细胞因子,并更有效地裂解靶细胞。GD2IL18CART体内抗肿瘤活性也更强,可清除GD2阳性肿瘤异种移植瘤。最后,我们建立了符合药品生产质量管理规范(GMP)的GD2IL18CART制备流程,并证实其在临床规模下可行且高效。 结论:这些结果为在儿童和成人神经母细胞瘤及其他GD2阳性癌症患者中开展GD2IL18CART临床研究奠定基础(EU CT 2022-501725-21-00)。相关评述见Locatelli和Quintarelli,第3361页。
PURPOSE: Cytokine-engineering of chimeric antigen receptor-redirected T cells (CAR T cells) is a promising principle to overcome the limited activity of canonical CAR T cells against solid cancers. EXPERIMENTAL DESIGN: We developed an investigational medicinal product, GD2IL18CART, consisting of CAR T cells directed against ganglioside GD2 with CAR-inducible IL18 to enhance their activation response and cytolytic effector functions in the tumor microenvironment. To allow stratification of patients according to tumor GD2 expression, we established and validated immunofluorescence detection of GD2 on paraffin-embedded tumor tissues. RESULTS: Lentiviral all-in-one vector engineering of human T cells with the GD2-specific CAR with and without inducible IL18 resulted in cell products with comparable proportions of CAR-expressing central memory T cells. Production of IL18 strictly depends on GD2 antigen engagement. GD2IL18CART respond to interaction with GD2-positive tumor cells with higher IFN and TNF cytokine release and more effective target cytolysis compared with CAR T cells without inducible IL18. GD2IL18CART further have superior in vivo antitumor activity, with eradication of GD2-positive tumor xenografts. Finally, we established GMP-compliant manufacturing of GD2IL18CART and found it to be feasible and efficient at clinical scale. CONCLUSIONS: These results pave the way for clinical investigation of GD2IL18CART in pediatric and adult patients with neuroblastoma and other GD2-positive cancers (EU CT 2022- 501725-21-00). See related commentary by Locatelli and Quintarelli, p. 3361.
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