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:LILRB1-directed CAR-T cells for the treatment of hematological malignancies.
然而,50% 的患者治疗失败,通常是由于 CD19 抗原丢失。
靶向 CD19 的 CAR-T 细胞已为复发/难治性 B 细胞恶性肿瘤确立新的治疗标准。然而,约 50% 患者治疗失败,常见原因是 CD19 抗原丢失。针对其他抗原的替代免疫疗法正在测试,但疗效有限,尤其是发生谱系转换或丢失 B 细胞表型的病例,凸显了开发新靶点的必要性。研究者利用高危 B 急性淋巴细胞白血病(B-ALL)患者来源样本开展细胞表面蛋白组分析,发现白细胞免疫球蛋白样受体 B1(LILRB1,CD85j)是 CAR-T 新靶点。LILRB1 是一种免疫抑制性受体,正常情况下仅在单核细胞和 B 细胞表达。研究者观察到,B-ALL 和 B 细胞非霍奇金淋巴瘤(B-NHL)中 LILRB1 稳定表达,即使接受 CD20/CD19 靶向免疫治疗后仍然如此。LILRB1 CAR-T 细胞在体外对 B-ALL/B-NHL 细胞具有抗原特异性抗肿瘤活性,包括耐受 CD19 CAR-T 的细胞;在体内 B-ALL 异种移植模型中也有效。此外,研究者在单核细胞型急性髓系白血病(AML)中发现 LILRB1,并证实体外和体内 LILRB1 CAR-T 细胞可杀伤 AML 细胞系。这些发现确立了 LILRB1 作为癌症免疫治疗的新靶点,并提供临床前证据,表明 LILRB1 CAR-T 可用于治疗包括既往免疫疗法耐药病例在内的血液系统恶性肿瘤,有望进一步开展临床开发。
CD19 CAR-T cells have established a new standard for relapsed/refractory B-cell malignancies. However, the treatment fails in 50% of patients, often due to CD19 antigen loss. Alternative immunotherapies targeting other antigens are being tested but show limited efficacy, especially in cases of lineage switching or loss of B-cell phenotype, highlighting the need for novel targets. Herein, we identified leukocyte-immunoglobulin-like-receptor-B1 (LILRB1, CD85j) as a novel target for CAR-T cells through cell surface proteomics on patient-derived samples of high-risk B-cell acute lymphoblastic leukemia (B-ALL). LILRB1, an immune inhibitory receptor, is normally expressed only on monocytes and B-cells. We observed stable LILRB1 expression in B-ALL and B-cell non-Hodgkin lymphoma (B-NHL), even after CD20/CD19-based immunotherapies. LILRB1 CAR-T cells showed antigen-specific antitumor activity in vitro against B-ALL/B-NHL cells, including those resistant to CD19 CAR-T-cells, and in vivo in B-ALL xenografts. Additionally, we identified LILRB1 in monocytic acute myeloid leukemia (AML) and demonstrated LILRB1 CAR-T cell cytotoxicity against AML cell lines in vitro and in vivo. These findings establish LILRB1 as a novel target for cancer immunotherapy and show evidence for the preclinical efficacy of LILRB1 CAR-T cells against haematological malignancies, including cases resistant to previous lines of immunotherapy, thus holding promise for further clinical development.
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