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:The bispecific antibody AZD0486: an overview of the clinical journey to date with a focus on follicular lymphoma.
The bispecific antibody AZD0486: an overview of the clinical journey to date with a focus on follicular lymphoma.
双特异性 TCE 是用于复发/难治性 B 细胞淋巴瘤治疗的最具前景的新型疗法之一。
引言:滤泡性淋巴瘤(FL)是最常见的惰性淋巴瘤。晚期FL患者通常对治疗有应答,但病程呈复发-缓解模式,每经一线后续治疗,无进展生存期都会缩短。虽然现有CD19靶向治疗(如CAR-T)治疗复发/难治性FL疗效令人鼓舞,但细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性综合征(ICANS)等免疫介导不良事件已有充分记录。AZD0486是一种全人源CD19×CD3双特异性T细胞衔接器(TCE),可诱导T细胞介导的细胞毒作用;其与CD3结合亲和力较低,因此细胞因子释放较少。综述范围:本文介绍AZD0486关键临床前数据,并详细评估正在开展的首次人体1期研究现有临床数据,包括安全性、疗效、药代动力学和未来开发计划。专家观点:双特异性TCE是复发/难治性B细胞淋巴瘤最有前景的新型疗法之一。与其他TCE相比,AZD0486完全缓解率高,高级别免疫介导毒性发生率低。重要的是,即使淋巴瘤已丢失CD20表达(这是CD20靶向TCE治疗失败的重要机制),AZD0486仍保持活性。
INTRODUCTION: Follicular lymphoma (FL) is the most common indolent lymphoma. Patients with advanced-stage FL typically respond to therapy, then follow a relapsing/remitting course, with shorter progression-free survival with each subsequent line of therapy. Whilst existing CD19-directed therapies such as CAR T-cell therapy have shown promising efficacy in the management of relapsed/refractory FL, immune-mediated adverse events, such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity (ICANS), are well described. AZD0486 is a fully human bispecific (CD19 CD3) T-cell engager (TCE) that induces T cell-mediated cytotoxicity but with low-affinity binding of CD3, resulting in a reduction in cytokine release. AREAS COVERED: In this review, we describe the key preclinical data for AZD0486 and evaluate in detail the available clinical data from the ongoing phase 1 first-in-human study, including safety, efficacy, pharmacokinetics, and future development plans. EXPERT OPINION: Bispecific TCEs are among the most promising novel therapies in use for the management of relapsed/refractory B-cell lymphomas. AZD0486 results in high complete response rates with low incidence of high-grade immune-mediated toxicity compared to alternative TCE therapies. Importantly, it remains active in patients with lymphomas that have lost CD20 expression, an important mechanism of treatment failure following CD20 targeting TCEs.
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