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:Interleukin-15-armoured GPC3 CAR T cells for patients with solid cancers.
这些结果共同表明,IL-15 可增强 GPC3 CAR T 细胞在患者体内的扩增、瘤内存活和抗肿瘤活性。
白细胞介素15(IL-15)可促进T淋巴细胞存活,并在CAR-T细胞疗效有限的实体瘤临床前模型中增强嵌合抗原受体(CAR)T细胞的抗肿瘤特性1-4。磷脂酰肌醇蛋白聚糖3(GPC3)在一组实体瘤中表达5-10。本研究报告了在人类中评估IL-15共表达对GPC3表达CAR-T细胞(下称GPC3 CAR-T细胞)影响的结果。队列1患者(NCT02905188和NCT02932956)接受GPC3 CAR-T细胞治疗,该疗法安全,但未产生客观抗肿瘤应答,细胞扩增在2周时达到峰值。队列2患者(NCT05103631和NCT04377932)接受共表达IL-15的GPC3 CAR-T细胞(15.CAR),其细胞扩增显著增加,疾病控制率达66%,抗肿瘤应答率达33%。输注15.CAR T细胞后细胞因子释放综合征发生率增加,可通过阻断IL-1/IL-6控制,或通过激活诱导型半胱天冬酶9安全开关迅速缓解。与无应答者相比,应答者的肿瘤浸润15.CAR T细胞中SWI/SNF表观遗传调控因子表达受抑,FOS和JUN家族成员以及I型干扰素信号相关基因表达上调。综上,这些结果表明IL-15可增加GPC3 CAR-T细胞在患者体内的扩增、肿瘤内存活和抗肿瘤活性。
Interleukin-15 (IL-15) promotes the survival of T lymphocytes and enhances the antitumour properties of chimeric antigen receptor (CAR) T cells in preclinical models of solid neoplasms in which CAR T cells have limited efficacy 1-4 . Glypican-3 (GPC3) is expressed in a group of solid cancers 5-10 , and here we report the evaluation in humans of the effects of IL-15 co-expression on GPC3-expressing CAR T cells (hereafter GPC3 CAR T cells). Cohort 1 patients ( NCT02905188 and NCT02932956 ) received GPC3 CAR T cells, which were safe but produced no objective antitumour responses and reached peak expansion at 2 weeks. Cohort 2 patients ( NCT05103631 and NCT04377932 ) received GPC3 CAR T cells that co-expressed IL-15 (15.CAR), which mediated significantly increased cell expansion and induced a disease control rate of 66% and antitumour response rate of 33%. Infusion of 15.CAR T cells was associated with increased incidence of cytokine release syndrome, which was controlled with IL-1/IL-6 blockade or rapidly ameliorated by activation of the inducible caspase 9 safety switch. Compared with non-responders, tumour-infiltrating 15.CAR T cells from responders showed repression of SWI/SNF epigenetic regulators and upregulation of FOS and JUN family members, as well as of genes related to type I interferon signalling. Collectively, these results demonstrate that IL-15 increases the expansion, intratumoural survival and antitumour activity of GPC3 CAR T cells in patients.
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