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:A Phase II Study of Acimtamig (AFM13) in Patients with CD30-Positive, Relapsed, or Refractory Peripheral T-cell Lymphomas.
观察到的有希望的临床疗效值得进一步研究,acimtamig用于R/R CD30+淋巴瘤患者的开发将继续与异体NK细胞联合进行。
复发或难治性(R/R)外周T细胞淋巴瘤(PTCL)患者通常预后较差,治疗选择有限。本研究评估了一种新型CD30/CD16A双特异性先天免疫细胞衔接器acimtamig(AFM13)在R/R PTCL患者中的疗效。
患者包括肿瘤细胞CD30表达≥1%且在接受≥1线全身治疗后R/R的患者。Acimtamig(200 mg)以8周为周期每周给药一次。主要终点是由独立审查委员会根据氟脱氧葡萄糖-PET评估的总缓解率;次要和探索性终点包括缓解持续时间、安全性、无进展生存期和总生存期。
108例患者的总体缓解率为32.4%[95%置信区间(CI),23.7,42.1],完全缓解率为10.2%(95% CI,5.2,17.5);中位缓解持续时间为2.3个月(95% CI,1.9,6.5)。R/R血管免疫母细胞性T细胞淋巴瘤患者的缓解人数最多[53.3%(95% CI,34.3,71.7)]。缓解与CD30表达水平、既往brentuximab vedotin治疗或类固醇预处理无关。Acimtamig表现出可耐受的安全性特征;最常见的治疗相关不良事件为输注相关反应,发生于27例患者(25.0%),以及中性粒细胞减少,发生于11例患者(10.2%)。未报告细胞因子释放综合征病例或acimtamig相关死亡。尽管在经过重度预处理的PTCL人群中表现出有前景的临床活性和可耐受的安全性,但该研究未达到主要终点的标准。
PURPOSE: Patients with relapsed or refractory (R/R) peripheral T-cell lymphoma (PTCL) generally have poor prognoses and limited treatment options. This study evaluated the efficacy of a novel CD30/CD16A bispecific innate cell engager, acimtamig (AFM13), in patients with R/R PTCL. PATIENTS AND METHODS: Patients included those with CD30 expression in ≥1% of tumor cells and who were R/R following ≥1 prior line of systemic therapy. Acimtamig (200 mg) was administered once weekly in 8-week cycles. The primary endpoint was the overall response rate by fluorodeoxyglucose-PET per independent review committee; secondary and exploratory endpoints included duration of response, safety, progression-free survival, and overall survival. RESULTS: The overall response rate in 108 patients was 32.4% [95% confidence interval (CI), 23.7, 42.1] with a complete response rate of 10.2% (95% CI, 5.2, 17.5); the median duration of response was 2.3 months (95% CI, 1.9, 6.5). Patients with R/R angioimmunoblastic T-cell lymphoma exhibited the greatest number of responses [53.3% (95% CI, 34.3, 71.7)]. Responses were independent of CD30 expression level, prior brentuximab vedotin treatment, or steroid premedication. Acimtamig exhibited a tolerable safety profile; the most common treatment-related adverse events were infusion-related reactions in 27 patients (25.0%) and neutropenia in 11 patients (10.2%). No cases of cytokine release syndrome or acimtamig-related deaths were reported. Despite exhibiting promising clinical activity and tolerable safety in a heavily pretreated PTCL population, the study did not meet the criteria for the primary endpoint. CONCLUSIONS: The promising clinical efficacy observed warrants further investigation, and development of acimtamig for patients with R/R CD30+ lymphomas continues in combination with allogeneic NK cells.
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