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免疫检查点抑制剂难治性肺癌中工程化 NK 细胞试验的中期报告

英文原题:Interim report on engineered NK cell trial in lung cancer refractory to immune checkpoint inhibitors.

查看英文原题

Interim report on engineered NK cell trial in lung cancer refractory to immune checkpoint inhibitors.

PubMed 2025/02/04(内容时间) JCI Insight Q1 · IF 6.8(JCR 2025)

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研究概要

未匹配的、同种异体的、冷冻保存的、即用型 sIL15_TRACK NK 细胞表达活化受体,归巢至表达其同源配体的肿瘤部位,并在输注后保留溶细胞活性,突显其作为实体瘤治疗方法的潜力。在低剂量下,该疗法给药安全,并在 6 例晚期和进展性 NSCLC 患者中的 3 例显示出初步活性证据。计划进行额外的剂量递增队列以及与 atezolizumab 联合给药。CLINICALTRIALS: gov NCT05334329。

研究思路结论见上方概要

非小细胞肺癌(NSCLC)仍然是癌症相关死亡的主要原因,因此需要探索替代治疗方法。肿瘤反应性或细胞因子激活杀伤细胞(TRACK)是PD-L1+、高度溶细胞性的NK细胞,来源于脐带血NK细胞,并经工程化改造以表达可溶性IL-15(sIL15),这些细胞在针对NSCLC的临床前研究中显示出前景。

我们评估了6例晚期、难治且进展的NSCLC患者接受低剂量不匹配、异体、现货型sIL15_TRACK NK细胞后的安全性、持久性、归巢和细胞毒活性。我们通过微滴数字PCR(ddPCR)、流式细胞术和免疫荧光染色评估了NK细胞的存在和持久性。

sIL15_TRACK NK细胞在每次输注后1小时达到峰值测量值,4小时后变为不可检测。在NSCLC中发现了活化NK细胞受体的同源配体。在末次输注后7天的肺肿瘤活检中观察到sIL15_TRACK NK细胞,证实了其持续存在和肿瘤归巢能力。从肺肿瘤中分离后,它们保留了细胞溶解功能。6例患者中有3例在重复影像学检查中达到疾病稳定,而其他患者则出现进展。

展开英文摘要原文

Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related mortality, necessitating the exploration of alternate therapeutic approaches. Tumor-reactive or activated-by-cytokine killers (TRACK) are PD-L1+, highly cytolytic NK cells derived from umbilical cord blood NK cells and engineered to express soluble IL-15 (sIL15), and these cells show promise in preclinical studies against NSCLC.

We assessed safety, persistence, homing, and cytotoxic activity in 6 patients with advanced, refractory, and progressing NSCLC who received a low dose of unmatched, allogeneic, off-the-shelf sIL15_TRACK NK cells. We evaluated NK cell presence and persistence with droplet digital PCR (ddPCR), flow cytometry, and immunofluorescence staining.

sIL15_TRACK NK cells had peak measurements at 1 hour and became undetectable 4 hours after each infusion. Cognate ligands to activating NK cell receptors were found in NSCLC. sIL15_TRACK NK cells were observed in a lung tumor biopsy 7 days after the final infusion, confirming their sustainment and tumor-homing ability. They retained cytolytic function following isolation from the lung tumor. Three of 6 patients achieved disease stabilization on repeat imaging, while the others progressed.

Unmatched, allogeneic, cryopreserved, off-the-shelf sIL15_TRACK NK cells express activating receptors, home to tumor sites that express their cognate ligands, and retain cytolytic activity after infusion, underscoring their potential as a therapeutic approach in solid tumors. At low doses, the therapy was safely administered and showed preliminary evidence of activity in 3 of 6 patients with advanced and progressive NSCLC. Additional dose escalation cohorts and coadministration with atezolizumab are planned. CLINICALTRIALS: gov NCT05334329. FUNDING: Funding was provided by CytoImmune Therapeutics and grants from the National Cancer Institute (CA266457, CA033572, and CA210087).

论文信息

作者
Villalona-Calero MA、Tian L、Li X、Palmer JM、Aceves C、Meisen H、Cortez C、Synold TW
第一作者单位
The Department of Medical Oncology and Experimental Therapeutics, Beckman Research Institute and Comprehensive Cancer Center.
通讯作者单位
Hematologic Malignancies Research Institute, Department of Hematology and Hematopoietic Stem Cell Transplantation.
文献类型
I 期临床试验 · 非美国政府资助研究
期刊
JCI insight2025 Feb 4
原文标识
PubMed 39903538 · DOI 10.1172/jci.insight.186890