CD81 通过阻断 CD274/PD-L1 的选择性自噬降解驱动放射抵抗性胶质母细胞瘤的免疫逃逸
CD81 drives immune evasion in radioresistant glioblastoma by blocking selective autophagic degradation of CD274/PD-L1.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:IGV-001 cellular immunotherapy for newly diagnosed glioblastoma: overcoming the logistic challenge.
IGV-001 cellular immunotherapy for newly diagnosed glioblastoma: overcoming the logistic challenge.
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我们在制定和执行本临床试验内部程序的过程中学到了很多。我们对 IGV-001 方案工作流程的描述可作为其他中心未来实施此类细胞免疫治疗的蓝图。我们进一步讨论了在试验期间学到的一些经验教训。
IGV-001是一种正在研究用于治疗胶质母细胞瘤的细胞免疫疗法(NCT04485949)。它利用患者的肿瘤来激发自体免疫反应。
该过程包括:(i) 开颅手术以最大程度安全切除胶质母细胞瘤,(ii) 将肿瘤离体后用针对胰岛素样生长因子1受体的反义寡脱氧核苷酸处理,随后进行照射,(iii) 将处理后的肿瘤置于多个生物扩散室中,并将其植入患者腹壁鞘内以引发免疫反应,以及 (iv) 48小时后取出扩散室。该临床试验在美国32个中心开放,符合条件的受试者按2:1比例随机分配,接受含有经处理的胶质母细胞瘤组织或安慰剂的生物扩散室。患者随后接受标准治疗,即同步放化疗联合替莫唑胺,之后进行6个周期的辅助替莫唑胺治疗。
IGV-001 方案流程的执行复杂,涉及多步骤过程,需要调动三级护理医院癌症中心内的多个服务部门,包括神经外科、神经肿瘤科、放射肿瘤科、神经放射科、癌症临床试验办公室和手术室人员,以及时满足预先规定的方案要求。
IGV-001 is a type of cellular immunotherapy currently being investigated for treating glioblastoma (NCT04485949). It uses the patient's tumor to elicit an autologous immune response.
The process involves (i) craniotomy for maximum safe resection of the glioblastoma, (ii) ex-vivo treatment of the tumor with an anti-sense oligodeoxynucleotide against insulin-like growth factor 1 receptor followed by irradiation, (iii) placement of the treated tumor in multiple bio-diffusion chambers, which are implanted into the patient's abdominal sheath to elicit an immune response, and (iv) explantation of the chambers 48 hours later. The clinical trial was open at 32 sites in the United States, and eligible subjects were randomized in a 2:1 ratio to receive bio-diffusion chambers containing either conditioned glioblastoma tissue or a placebo. Patients subsequently proceeded to standard-of-care treatment with concomitant radiation-temozolomide, followed by 6 cycles of adjuvant temozolomide.
The execution of the IGV-001 protocol procedure is complicated and involves a multi-step process requiring mobilization of multiple services within the cancer center of a tertiary care hospital, including neurosurgery, neuro-oncology, radiation oncology, neuroradiology, cancer clinical trial office, and operating room personnel to fulfill the pre-specified protocol requirements in a timely fashion.
We have learned a great deal in the process of developing and executing our internal procedures for this clinical trial. Our description of the IGV-001 protocol workflow may serve as a "blueprint" for future implementation of this type of cellular immunotherapy at other centers. We further discuss some of the lessons we have learned during the trial.
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