← 返回前沿论文

靶向 CD19/20 的双特异性 CAR-T 细胞治疗复发或难治性 B 细胞非霍奇金淋巴瘤患者:一项 I/II 期试验

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.

PubMed 2024/08/07(内容时间) Blood Cancer J Q1 · IF 13.8(JCR 2025)

研究概要

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。

中文摘要

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。

展开英文摘要原文

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.

论文信息

作者
Wang L、Fang C、Kang Q、Huang W、Chen Z、Zhao W、Wang L、Wang Y
第一作者单位
Department of Hematology and Oncology, Shenzhen University General Hospital, Shenzhen Key Laboratory, Hematology Institution of Shenzhen University, Shenzhen Clinical Research Center for Hematologic Disease, International Cancer Center, Shenzhen University Health Science Center, Shenzhen University, Xueyuan AVE 1098, Shenzhen, 518000, China.China
通讯作者单位
Department of Hematology and Oncology, Shenzhen University General Hospital, Shenzhen Key Laboratory, Hematology Institution of Shenzhen University, Shenzhen Clinical Research Center for Hematologic Disease, International Cancer Center, Shenzhen University Health Science Center, Shenzhen University, Xueyuan AVE 1098, Shenzhen, 518000, China. yuli@szu.edu.cn.China
文献类型
I 期临床试验 · II 期临床试验 · 非美国政府资助研究
期刊
Blood cancer journal2024 Aug 7
原文标识
PubMed 39112452 · DOI 10.1038/s41408-024-01105-8