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GD2 靶向 CAR-T 细胞治疗神经母细胞瘤患者的长期结局

英文原题:Long-term outcomes of GD2-directed CAR-T cell therapy in patients with neuroblastoma.

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Long-term outcomes of GD2-directed CAR-T cell therapy in patients with neuroblastoma.

PubMed 2025/02/17(内容时间) Nat Med Q1 · IF 52.5(JCR 2025)

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中文摘要

在一项于2004年至2009年开放入组的1期临床试验中,我们用EBV(Epstein-Barr病毒)特异性T淋巴细胞和CD3活化T细胞治疗神经母细胞瘤患儿,这些细胞均表达靶向GD2的CAR,但不含嵌入的共刺激序列(第一代CAR)。这些CAR整合了条形码序列,以追踪每一回输的细胞群。

我们既往报告了长达5年的结局,现在报告长达18年的长期结局。在11例回输时有活动性疾病的患者中,3例获得完全缓解,其中2例维持缓解,1例维持8年直至失访,另1例维持超过18年。在8例接受CAR-T 时无疾病证据的患者中,5例在回输后10年至15年间的末次随访时无病。随访期间检测到间歇性低水平转基因,且在长期生存者中持续存在显著更久。尽管使用的是因缺乏共刺激结构域而已不再采用的第一代载体,复发/难治性神经母细胞瘤患者在接受GD2 CAR-T 细胞治疗后仍实现了长期疾病控制,包括1例复发疾病现已缓解超过18年的患者。ClinicalTrials.gov标识符:NCT00085930。

展开英文摘要原文

In a phase 1 clinical trial open to accrual from 2004 to 2009, we treated children with neuroblastoma with Epstein-Barr virus (EBV)-specific T lymphocytes and CD3-activated T cells-each expressing chimeric antigen receptors (CARs) targeting GD2 but without an embedded co-stimulatory sequence (first-generation CARs). These CARs incorporated barcoded sequences to track each infused population.

We previously reported outcomes up to 5 years and now report long-term outcomes up to 18 years. Of 11 patients with active disease at infusion, three achieved a complete response that was sustained in two patients, one for 8 years until lost to follow-up and one for more than 18 years. Of eight patients with no evidence of disease at the time of CAR-T administration, five are disease free at their last follow-up between 10 years and 15 years after infusion.

Intermittent low levels of transgene were detected during the follow-up period with significantly greater persistence in those who were long-term survivors. Despite using first-generation vectors that are no longer employed because of the lack of co-stimulatory domains, patients with relapsed/refractory neuroblastoma achieved long-term disease control after receiving GD2 CAR-T cell therapy, including one patient now in remission of relapsed disease for more than 18 years. ClinicalTrials. gov identifier: NCT00085930 .

论文信息

作者
Li CH、Sharma S、Heczey AA、Woods ML、Steffin DHM、Louis CU、Grilley BJ、Thakkar SG
第一作者单位
Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital and Houston Methodist Hospital, Houston, TX, USA.United States
通讯作者单位
Center for Cell and Gene Therapy, Baylor College of Medicine, Texas Children's Hospital and Houston Methodist Hospital, Houston, TX, USA. hheslop@bcm.edu.United States
文献类型
I 期临床试验
期刊
Nature medicine2025 Apr
原文标识
PubMed 39962287 · DOI 10.1038/s41591-025-03513-0