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:Automated manufacturing and characterization of clinical grade autologous CD20 CAR T cells for the treatment of patients with stage III/IV melanoma.
CliniMACS Prodigy 平台非常适合抗 CD20 CAR-T 细胞的去中心化 POC 生产,并且同样可能适用于针对其他靶点的 CAR-T 细胞的快速、自动化生产。
引言:过去十年中,嵌合抗原受体(CAR)修饰 T 细胞的即时制造(POC)发展迅速。除使用 CD19 CAR-T 治疗血液系统疾病外,靶向多种肿瘤相关表位也日益受到关注。方法:我们报告在一项 I 期临床试验(NCT03893019)中,为黑色素瘤患者制备自体抗 CD20 CAR-T 细胞并对其进行表征的结果。使用第二代慢病毒载体,并通过 CliniMACS Prodigy 制备 CD20 CAR-T 细胞。结果:我们证实,在两个不同生产场所制造的产品,其细胞组成和功能一致。收获第 12 天时,T 细胞纯度 >98.5%,CD4/CD8 比值为 2.5–5.5,转导率为 34%–61%。中位扩增倍数为 53 倍(范围 42–65 倍),收获时 CAR-T 细胞数量为 1.7–3.8 × 10⁹,足以支持计划中的剂量递增步骤(每千克体重 1 × 10⁵、1 × 10⁶、1 × 10⁷ 个细胞)。对部分产品开展的补充研究发现,CAR+ 细胞主要呈中央记忆 T 细胞表型。所有受测 CAR-T 产品在遇到 CAR 靶细胞后均能激活 T 细胞,表现为促炎细胞因子释放增加及 CAR-T 细胞扩增增强。值得注意的是,不同个体间在细胞内在的细胞因子释放和扩增能力方面存在差异。CAR 介导的 T 细胞激活取决于 CAR 对应抗原的水平。讨论:总之,CliniMACS Prodigy 平台适用于抗 CD20 CAR-T 细胞的分散式即时制造,也可能用于快速、自动化地制造靶向其他抗原的 CAR-T 细胞。临床试验注册:ClinicalTrials.gov,NCT03893019。
INTRODUCTION: Point-of-care (POC) manufacturing of chimeric antigen receptor (CAR) modified T cell has expanded rapidly over the last decade. In addition to the use of CD19 CAR T cells for hematological diseases, there is a growing interest in targeting a variety of tumor-associated epitopes. METHODS: Here, we report the manufacturing and characterization of autologous anti-CD20 CAR T cells from melanoma patients within phase I clinical trial (NCT03893019). Using a second-generation lentiviral vector for the production of the CD20 CAR T cells on the CliniMACS Prodigy . RESULTS: We demonstrated consistency in cell composition and functionality of the products manufactured at two different production sites. The T cell purity was >98.5%, a CD4/CD8 ratio between 2.5 and 5.5 and transduction rate between 34% and 61% on day 12 (harvest). Median expansion rate was 53-fold (range, 42-65-fold) with 1.7-3.8 10 9 CAR T cells at harvest, a sufficient number for the planned dose escalation steps (1 10 5 /kg, 1 10 6 /kg, 1 10 7 /kg BW). Complementary research of some of the products pointed out that the CAR+ cells expressed mainly central memory T-cell phenotype. All tested CAR T cell products were capable to translate into T cell activation upon engagement of CAR target cells, indicated by the increase in pro-inflammatory cytokine release and by the increase in CAR T cell amplification. Notably, there were some interindividual, cell-intrinsic differences at the level of cytokine release and amplification. CAR-mediated T cell activation depended on the level of CAR cognate antigen. DISCUSSION: In conclusion, the CliniMACS Prodigy platform is well suited for decentralized POC manufacturing of anti-CD20 CAR T cells and may be likewise applicable for the rapid and automated manufacturing of CAR T cells directed against other targets. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT03893019?cond=Melanoma&term=NCT03893019&rank=1, identifier NCT03893019.
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