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:Interleukin-15-armored GPC3-CAR T cells for patients with solid cancers.
Interleukin-15-armored GPC3-CAR T cells for patients with solid cancers.
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白细胞介素-15(IL-15)可促进 T 淋巴细胞存活,并在 CAR-T 细胞疗效有限的实体瘤临床前模型中增强其抗肿瘤特性。聚糖-3(GPC3)表达于一类实体瘤中。
本研究首次在人体评估共表达 IL-15 对 GPC3-CAR-T 细胞的影响。队列 1 患者(NCT02905188/NCT02932956)接受 GPC3-CAR-T 细胞治疗,安全性良好,但未出现客观抗肿瘤应答,且细胞扩增峰值出现在两周时。队列 2 患者(NCT05103631/NCT04377932)接受共表达 IL-15 的 GPC3-CAR-T 细胞(15.CAR),细胞扩增显著增加,疾病控制率达 66%,抗肿瘤缓解率达 33%。输注 15.CAR-T 细胞后细胞因子释放综合征发生率升高,但通过激活诱导型 caspase 9 安全开关可迅速缓解。与无应答者相比,应答者肿瘤浸润性 15.CAR-T 细胞中 SWI/SNF 表观遗传调控因子表达受抑,FOS 和 JUN 家族成员及 I 型干扰素信号相关基因表达上调。
总体而言,这些结果表明 IL-15 可提高患者 GPC3-CAR-T 细胞的扩增、瘤内存活和抗肿瘤活性。
Interleukin-15 (IL15) promotes the survival of T lymphocytes and enhances the antitumor properties of CAR T cells in preclinical models of solid neoplasms in which CAR T cells have limited efficacy 1-4 . Glypican-3 (GPC3) is expressed in a group of solid cancers 5-10 , and here we report the first evaluation in humans of the effects of IL15 co-expression on GPC3-CAR T cells. Cohort 1 patients (NCT02905188/NCT02932956) received GPC3-CAR T cells, which were safe but produced no objective antitumor responses and reached peak expansion at two weeks. Cohort 2 patients (NCT05103631/NCT04377932) received GPC3-CAR T cells that co-expressed IL15 (15.
CAR), which mediated significantly increased cell expansion and induced a disease control rate of 66% and antitumor response rate of 33%. Infusion of 15. CAR T cells was associated with increased incidence of cytokine release syndrome, which was rapidly ameliorated by activation of the inducible caspase 9 safety switch. Compared to non-responders, tumor-infiltrating 15.
CAR T cells from responders showed repression of SWI/SNF epigenetic regulators and upregulation of FOS and JUN family members as well as genes related to type I interferon signaling. Collectively, these results demonstrate that IL15 increases the expansion, intratumoral survival, and antitumor activity of GPC3-CAR T cells in patients.
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