不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:(68)Ga-grazytracer PET for noninvasive assessment of response to immunotherapy in solid tumors and lymphomas: a phase 1/2 clinical trial.
(68)Ga-grazytracer PET for noninvasive assessment of response to immunotherapy in solid tumors and lymphomas: a phase 1/2 clinical trial.
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为解决无创评估患者免疫治疗疗效的临床难题,我们在此使用靶向颗粒酶B的68Ga-grazytracer进行正电子发射断层扫描(PET),颗粒酶B是活化CD8+ T细胞分泌的关键效应分子。在这项1/2期临床试验(NCT05000372)中,纳入了24例接受免疫治疗的实体瘤和淋巴瘤患者的多样化队列,免疫治疗包括免疫检查点抑制剂(单用或联合化疗)和CAR-T 细胞治疗,我们考察了68Ga-grazytracer的体内行为。主要终点为安全性、生物分布、颗粒酶B特异性以及68Ga-grazytracer的预测效用,次要终点为68Ga-grazytracer摄取与肿瘤免疫表型之间的关系。68Ga-grazytracer表现出安全性特征,并在患者中特异性靶向颗粒酶B。68Ga-grazytracer PET对短期预后和无进展生存期的预测价值优于常规评估标准,包括RECIST 1.1和PERCIST。
此外,免疫表型为“非荒漠”型的肿瘤中68Ga-grazytracer摄取显著高于免疫“荒漠”型肿瘤,从而达到了本试验的主要和次要终点。
总体而言,我们成功利用68Ga-grazytracer PET在人体中可视化了CD8+ T细胞效应功能,为改进免疫治疗评估、患者分层和治疗规划提供了见解。
To tackle the clinical challenge of noninvasively assessing immunotherapy efficacy in patients, here we used positron emission tomography (PET) with 68 Ga-grazytracer, which targets granzyme B, a crucial effector molecule secreted by activated CD8 + T cells. In this phase 1/2 clinical trial (NCT05000372) involving a diverse cohort of 24 patients with solid tumors and lymphomas who received immunotherapies, including immune checkpoint inhibitors (either alone or with chemotherapies) and chimeric antigen receptor-T cell therapy, we examined the in vivo behaviors of 68 Ga-grazytracer.
Primary endpoints were safety, biodistribution, granzyme B specificity, and the predictive utility of 68 Ga-grazytracer, while secondary endpoint was the relationship between 68 Ga-grazytracer uptake and tumor immune phenotype. 68 Ga-grazytracer exhibited a safe profile and specifically targeted granzyme B in patients. 68 Ga-grazytracer PET showed superior predictive value for short-term prognosis and progression-free survival than those of conventional assessment criteria, including RECIST 1. 1 and PERCIST.
Moreover, the uptake of 68 Ga-grazytracer in tumors was significantly higher in those with a "non-desert" immune phenotype than those with an immune "desert" phenotype, thereby meeting the primary and secondary endpoints of this trial. Collectively, we successfully visualized CD8 + T cell effector function in humans using 68 Ga-grazytracer PET, offering insights for enhancing immunotherapy assessment, patient stratification and treatment planning.
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