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:Targeting high-risk multiple myeloma genotypes with optimized anti-CD70 CAR T cells.
这些发现共同支持以优化 CAR-T 靶向 CD70 治疗骨髓瘤的前景,以及该方法的未来临床转化。
尽管靶向B细胞成熟抗原(BCMA)的嵌合抗原受体(CAR)T细胞(CAR-T)治疗多发性骨髓瘤已取得成功,但具有高危细胞遗传学特征的患者仍最早复发,亟需额外治疗选择。本研究发现CD70在高危骨髓瘤肿瘤中选择性上调;CD70已被广泛认为是其他癌症中有利的免疫治疗靶点。我们采用结构指导设计,构建基于CD27的抗CD70 CAR-T设计,其性能优于所有受试的单链可变片段型CAR,体内CAR-T扩增提高超过80倍。基于机器学习的表观遗传分析预测了驱动高危骨髓瘤中CD70上调的关键转录因子及转录网络。分别靶向CD70或BCMA的双靶点CAR-T显示出避免抗原逃逸介导耐药的潜在策略。综上,这些发现支持采用优化CAR-T靶向骨髓瘤CD70,并为该方法未来临床转化提供依据。
Despite the success of B-cell maturation antigen (BCMA)-targeting chimeric antigen receptor (CAR) T cells (CAR-Ts) in multiple myeloma, patients with high-risk cytogenetic features continue to relapse most quickly and are in urgent need of additional therapeutic options. Here, we identify CD70, widely recognized as a favorable immunotherapy target in other cancers, as a specifically upregulated cell surface antigen in high-risk myeloma tumors. We use a structure-guided design to define a CD27-based anti-CD70 CAR-T design that outperforms all tested single-chain variable fragment-based CARs, leading to >80-fold improved CAR-T expansion in vivo. Epigenetic analysis via machine learning predicts key transcription factors and transcriptional networks driving CD70 upregulation in high-risk myeloma. Dual-targeting CAR-Ts against either CD70 or BCMA demonstrate a potential strategy to avoid antigen escape-mediated resistance. Together, these findings support the promise of targeting CD70 with optimized CAR-Ts in myeloma as well as future clinical translation of this approach.
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