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 CD70-CD27 Axis in Cancer Immunotherapy: Predictive Biomarker and Therapeutic Target.
CD27-CD70相互作用被认为是T细胞启动和扩增的阳性共刺激途径。
CD27-CD70相互作用被认为是T细胞启动和扩增的阳性共刺激通路。然而,近期研究表明,癌症中慢性的CD27-CD70相互作用可导致T细胞凋亡,使其功能失调。CD70不仅由血液系统肿瘤表达,也由实体肿瘤细胞表达。这种表达受HIF、EB病毒感染和上皮-间质转化的调控。肿瘤内T细胞上的CD27表达可识别耗竭和功能失调的T细胞,以及具有增强免疫抑制活性的调节性T细胞。鉴于CD70在某些肿瘤细胞上的优先表达,多种治疗策略,包括抗体-药物偶联物、抗CD70 CAR-T细胞和抗CD70 mAbs,已在多种临床前模型和临床试验中进行了研究。迄今为止,最显著的临床结果见于血液系统恶性肿瘤。然而,尚未开发出专门靶向有害CD27-CD70相互作用的治疗工具。大多数靶向CD70的mAbs也会清除其他表达CD70的细胞,如活化的T细胞。有趣的是,慢性CD27-CD70相互作用导致患者血浆中可检测到可溶性CD27(sCD27)的释放。血浆中高水平的sCD27与肾癌、黑色素瘤和非小细胞肺癌中对anti-PD-(L)1的耐药相关。相反,在接受了毒性更大的anti-PD-1联合anti-CTLA-4治疗的黑色素瘤患者中,sCD27缺乏预测性影响,这可能为采用该方案进行强化治疗提供依据。因此,CD27-CD70轴既可作为指导免疫治疗选择的潜在生物标志物,也可作为一种新的临床靶点。
The CD27-CD70 interaction is recognized as a positive costimulatory pathway for T-cell priming and expansion. However, recent studies showed that chronic CD27-CD70 interaction in cancer can lead to apoptosis of T cells, rendering them dysfunctional. CD70 is expressed not only by hematologic tumors but also by solid tumor cells. This expression is regulated by HIF, Epstein-Barr virus infection, and epithelial-mesenchymal transition. CD27 expression on intratumoral T cells identifies exhausted and dysfunctional T cells, as well as regulatory T cells with enhanced immunosuppressive activity. Given the preferential expression of CD70 on certain tumor cells, several therapeutic approaches, including antibody-drug conjugates, anti-CD70 chimeric antigen receptor T cells, and anti-CD70 mAbs, have been investigated in various preclinical models and clinical trials. To date, the most significant clinical results are observed in hematologic malignancies. However, no therapeutic tools specifically targeting the deleterious CD27-CD70 interaction have been developed. Most CD70-targeting mAbs also deplete other CD70-expressing cells, such as activated T cells. Interestingly, chronic CD27-CD70 interaction results in the release of detectable soluble CD27 (sCD27) in patient plasma. The presence of high levels of sCD27 in plasma correlates with resistance to anti-PD-(L)1 in renal cancer, melanoma, and non-small cell lung cancer. Conversely, the absence of a predictive impact of sCD27 in patients with melanoma treated with the more toxic combination of anti-PD-1 and anti-CTLA-4 may justify therapeutic escalation with this regimen. Thus, the CD27-CD70 axis may serve as both a potential biomarker to guide the choice of immunotherapy and a novel clinical target.
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