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:PD-1 blockade does not improve efficacy of EpCAM-directed CAR T-cell in lung cancer brain metastasis.
CAR-T 细胞疗法治疗脑部恶性肿瘤似乎前景可期。
背景:肺癌脑转移预后极差,亟需创新治疗策略。嵌合抗原受体(CAR)T 细胞在血液系统恶性肿瘤中显示出前景,但由于肿瘤免疫抑制环境,其治疗脑转移等实体瘤的疗效有限。PD-L1/PD-1 通路会抑制肿瘤微环境中的 CAR-T 细胞活性,因此可能成为提高疗效的靶点。本研究旨在评估抗 PD-1 抗体对 CAR-T 细胞治疗肺癌脑转移的影响。方法:我们使用具有免疫功能的小鼠同系原位脑转移模型,并反复进行颅内双光子激光扫描显微成像,从而在体内以单细胞水平随时间表征红色荧光肿瘤细胞和 CAR-T 细胞。将表达红色荧光的 EpCAM 转导 Lewis 肺癌细胞(EpCAM/tdTomato LL/2 细胞)植入颅内。脑转移形成后,将靶向 EpCAM 的 CAR-T 细胞注射至邻近脑组织,并给予动物抗 PD-1 抗体或同型对照。结果:与接受不含 CAR 的 T 细胞对照组相比,接受 EpCAM 靶向 CAR-T 细胞的小鼠在脑实质注射后的早期肿瘤内 CAR-T 细胞密度更高,同时肿瘤生长减缓并转化为生存获益。然而,额外给予抗 PD-1 治疗既未影响肿瘤内 CAR-T 细胞持久性,也未影响肿瘤生长,因此没有带来额外治疗效果。结论:CAR-T 细胞治疗脑部恶性肿瘤显示出前景,但额外抗 PD-1 治疗并未增强肿瘤内 CAR-T 细胞持久性或效应功能,凸显了开发新策略以改善 CAR-T 细胞治疗实体瘤的必要性。
BACKGROUND: Lung cancer brain metastasis has a devastating prognosis, necessitating innovative treatment strategies. While chimeric antigen receptor (CAR) T-cell show promise in hematologic malignancies, their efficacy in solid tumors, including brain metastasis, is limited by the immunosuppressive tumor environment. The PD-L1/PD-1 pathway inhibits CAR T-cell activity in the tumor microenvironment, presenting a potential target to enhance therapeutic efficacy. This study aims to evaluate the impact of anti-PD-1 antibodies on CAR T-cell in treating lung cancer brain metastasis. METHODS: We utilized a murine immunocompetent, syngeneic orthotopic cerebral metastasis model for repetitive intracerebral two-photon laser scanning microscopy, enabling in vivo characterization of red fluorescent tumor cells and CAR T-cell at a single-cell level over time. Red fluorescent EpCAM-transduced Lewis lung carcinoma cells ( EpCAM/tdt LL/2 cells) were implanted intracranially. Following the formation of brain metastasis, EpCAM-directed CAR T-cell were injected into adjacent brain tissue, and animals received either anti-PD-1 or an isotype control. RESULTS: Compared to controls receiving T-cell lacking a CAR, mice receiving EpCAM-directed CAR T-cell showed higher intratumoral CAR T-cell densities in the beginning after intraparenchymal injection. This finding was accompanied with reduced tumor growth and translated into a survival benefit. Additional anti-PD-1 treatment, however, did not affect intratumoral CAR T-cell persistence nor tumor growth and thereby did not provide an additional therapeutic effect. CONCLUSION: CAR T-cell therapy for brain malignancies appears promising. However, additional anti-PD-1 treatment did not enhance intratumoral CAR T-cell persistence or effector function, highlighting the need for novel strategies to improve CAR T-cell therapy in solid tumors.
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