CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Reprogramming the neuroblastoma tumor immune microenvironment to enhance GPC2 CAR T cells.
Reprogramming the neuroblastoma tumor immune microenvironment to enhance GPC2 CAR T cells.
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肿瘤归巢能力差及免疫抑制性肿瘤微环境(TME)限制了嵌合抗原受体(CAR)T细胞治疗实体瘤(如神经母细胞瘤)的疗效。我们此前优化了靶向GPC2的CAR,并在人成神经细胞瘤异种移植模型中取得良好结果,进而推动临床转化;然而,尚无研究在免疫功能完整模型中开展临床前测试。
因此,我们采用临床使用的D3-GPC2靶向单链可变片段(NCT05650749)构建小鼠GPC2 CAR-T 细胞,并在神经母细胞瘤同系移植模型中检测。GPC2 CAR-T 细胞治疗后对肿瘤进行免疫分析发现,TME发生显著重编程;最突出的是,CAR-T 细胞瘤内持久性差与髓源性抑制细胞(MDSC)募集增加相关,且伴随募集MDSC的CXCL1/2趋化因子增加。这些肿瘤浸润MDSC可在离体条件下直接抑制GPC2 CAR-T 细胞活化、增殖和细胞毒性。为利用该趋化因子梯度并减少MDSC向肿瘤迁移,我们工程化改造GPC2 CAR-T 细胞,使其表达CXCL1/2受体CXCR2。表达CXCR2的装甲化GPC2 CAR-T 细胞可向CXCL1/2梯度迁移,增强抗神经母细胞瘤疗效,并降低TME中的MDSC水平。
综上,这些发现提示,必须在免疫功能完整模型中研究CAR-T 细胞,以界定实体瘤免疫逃逸机制,并理性设计装甲化策略,从而实现持久临床疗效。
Poor tumor trafficking and the immunosuppressive tumor microenvironment (TME) limit chimeric antigen receptor (CAR) T cell efficacy in solid tumors, such as neuroblastoma.
We previously optimized GPC2 CARs in human neuroblastoma xenografts leading to clinical translation; however, there have not been preclinical studies using immunocompetent models.
Thus, here we generated murine GPC2 CAR T cells using the D3-GPC2-targeting single-chain variable fragment being utilized clinically (NCT05650749) and tested them in neuroblastoma syngeneic allografts. Immune-profiling of GPC2 CAR T cell-treated tumors revealed significant reprogramming of the TME, most notably poor intra-tumor CAR T cell persistence being associated with increased recruitment of myeloid-derived suppressor cells (MDSCs), along with MDSC-recruiting CXCL1/2 chemokines.
These tumor-infiltrating MDSCs directly inhibited GPC2 CAR T cell activation, proliferation, and cytotoxicity ex vivo. To both capitalize on this chemokine gradient and mitigate MDSC-tumor trafficking, we engineered GPC2 CAR T cells to express the CXCL1/2 receptor, CXCR2. CXCR2-armored GPC2 CAR T cells migrated toward CXCL1/2 gradients, enhanced anti-neuroblastoma efficacy, and reduced the level of MDSCs in the TME.
Together, these findings suggest CAR T cell studies in immunocompetent models are imperative to define mechanisms of solid tumor immune escape and rationally design armoring strategies that will lead to durable clinical efficacy.
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