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:Enhancing mesothelin CAR T cell therapy for pancreatic cancer with an oncolytic herpes virus boosting CAR target antigen expression.
综合来看,这些结果表明,HSV-MSLN 重编程 TME 和 TDLN 中的免疫细胞,并与 MSLN-CAR T 细胞协同增强抗肿瘤反应,从而产生更强的治疗效果。
间皮素(MSLN)在包括胰腺癌在内的多种实体瘤中广泛表达,因此是CAR T细胞疗法的重要靶抗原。然而,MSLN靶向CAR T细胞治疗胰腺癌在临床试验中的疗效有限,最佳应答常为短暂疾病稳定。MSLN表达异质性及其随时间丢失,加上免疫抑制性肿瘤微环境(TME),是限制疗效的关键因素。溶瘤病毒是一类新兴癌症疗法,可在肿瘤细胞内复制并将TME重塑为免疫原性状态。本研究构建了一种表达人MSLN的溶瘤单纯疱疹病毒1型(HSV-MSLN),并在小鼠胰腺导管腺癌模型中评估其与MSLN-CAR T细胞的联合应用。体外实验中,HSV-MSLN有效诱导小鼠胰腺癌细胞表达MSLN,随后造成细胞裂解。共培养时,HSV-MSLN感染的癌细胞可激活MSLN-CAR T细胞,后者能够有效清除感染细胞。体内实验中,HSV-MSLN使MSLN呈递于肿瘤细胞表面,并将TME重塑为免疫原性状态。联合治疗显著增强抗肿瘤疗效,促进活化、增殖的CD8+ CAR T细胞,同时减少肿瘤中的PD-1+ TIM-3+耗竭型内源性CD8+ T细胞及调节性T细胞。此外,联合治疗增加肿瘤及肿瘤引流淋巴结(TDLN)中的迁移性XCR1+ CD103+树突状细胞(DC),并扩增具有中央记忆和效应记忆表型的CD44+ CD8+ T细胞。总之,这些结果表明,HSV-MSLN可重塑TME及TDLN中的免疫细胞,并与MSLN-CAR T细胞协同增强抗肿瘤应答,从而获得更强治疗效果。
Mesothelin (MSLN) is a prominent target antigen for CAR T cell therapy due to its extensive expression in various solid tumors, including pancreatic cancer. However, the therapeutic efficacy of MSLN-targeted CAR T cell therapy has been limited in clinical trials for pancreatic cancer, often resulting in temporary stable disease as the best response. The heterogeneous expression of MSLN and its loss over time, along with the immunosuppressive tumor microenvironment (TME), are key factors restricting effectiveness. Oncolytic viruses are emerging cancer therapies that replicate in tumor cells and remodel the TME into an immunogenic state. Here, we engineered an oncolytic herpes simplex virus type 1 expressing human MSLN (HSV-MSLN) and evaluated its combination with MSLN-CAR T cells in a murine pancreatic ductal adenocarcinoma model. In vitro, HSV-MSLN effectively induced MSLN expression on murine pancreatic cancer cells, with subsequent cell lysis. In co-culture, HSV-MSLN-infected cancer cells activated MSLN-CAR T cells, which effectively eliminated the infected cells. In vivo, HSV-MSLN delivered MSLN on the tumor cell surface and reprogrammed the TME toward an immunogenic state. The combination therapy significantly enhanced antitumor efficacy, inducing activated, proliferative CD8 + CAR T cells and reducing PD-1 + TIM-3 + exhausted endogenous CD8 + T cells and regulatory T cells in tumors. Furthermore, the combination therapy increased migratory XCR1 + CD103 + dendritic cells (DCs) in tumors and tumor-draining lymph nodes (TDLNs) while expanding CD44 + CD8 + T cells with central and effector memory phenotypes. Taken together, these results demonstrate that HSV-MSLN reprograms immune cells in the TME and TDLNs and synergizes with MSLN-CAR T cells to enhance antitumor responses, leading to a more robust therapeutic effect.
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