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:Bispecific CAR-T cells targeting CD19/20 in patients with relapsed or refractory B cell non-Hodgkin lymphoma: a phase I/II trial.
非霍奇金淋巴瘤(NHL)是血液系统常见的恶性肿瘤,传统治疗对复发/难治性NHL(R/R NHL)患者疗效有限,尤其是弥漫大B细胞淋巴瘤(DLBCL)患者。
非霍奇金淋巴瘤(NHL)是血液系统常见恶性肿瘤,传统疗法对复发/难治性 NHL(R/R NHL)患者疗效有限,尤其是弥漫大 B 细胞淋巴瘤(DLBCL)患者。嵌合抗原受体(CAR)T 细胞疗法是治疗 R/R 血液系统恶性肿瘤的一种新型有效免疫治疗策略,但可能因体内 CAR-T 细胞丢失或抗原丢失而发生复发。避免 CAR-T 细胞治疗后抗原丢失的一种策略是同时再靶向一个抗原。靶向 CD19 和 CD22 的串联 CAR 已证实串联 CAR-T 细胞疗法治疗 R/R B-ALL 的可靠性。本研究探讨串联 CD19/20 CAR-T 治疗 R/R B 细胞 NHL 的治疗潜力。在一项开放标签、单臂试验中,评估了自体 CD19/20 CAR-T 细胞在 11 例 R/R B 细胞 NHL 成年患者中的疗效和安全性。大多数患者达到完全缓解,显示出串联 CD19/20 CAR-T 细胞的疗效和安全性。CAR-T 细胞的 TCR 库多样性在输注后降低。体内扩增的 TCR 克隆主要来源于 IP 中免疫相关信号通路相关基因表达增高的 TCR 克隆。CAR-T 细胞在体内的动力学与免疫应答及细胞溶解/细胞毒性相关基因表达增加有关。
Non-Hodgkin lymphoma (NHL) is a common malignancy in the hematologic system, and traditional therapy has limited efficacy for people with recurrent/refractory NHL (R/R NHL), especially for patients with diffuse large B cell lymphoma (DLBCL). Chimeric antigen receptor (CAR) T-cell therapy is a novel and effective immunotherapy strategy for R/R hematopoietic malignancies, but relapses can occur due to the loss of CAR-T cells in vivo or the loss of antigen. One strategy to avoid antigen loss after CAR-T cell therapy is to target one more antigen simultaneously. Tandem CAR targeting CD19 and CD22 has demonstrated the reliability of tandem CAR-T cell therapy for R/R B-ALL. This study explores the therapeutic potential of tandem CD19/20 CAR-T in the treatment of R/R B cell NHL. The efficacy and safety of autologous CD19/20 CAR-T cells in eleven R/R B cell NHL adult patients were evaluated in an open-label, single-arm trial. Most patients achieved complete response, exhibiting the efficacy and safety of tandem CD19/20 CAR-T cells. The TCR repertoire diversity of CAR-T cells decreased after infusion. The expanded TCR clones in vivo were mainly derived from TCR clones that had increased expression of genes associated with immune-related signaling pathways from the infusion product (IP). The kinetics of CAR-T cells in vivo were linked to an increase in the expression of genes related to immune response and cytolysis/cytotoxicity.
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