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:Phase 1/2 trial of anti-CD7 allogeneic WU-CART-007 for patients with relapsed/refractory T-cell malignancies.
在入组的28例患者中,13例接受了推荐的2期剂量(RP2D)900 × 106个WU-CART-007细胞,并进行了增强的清淋预处理。
复发/难治性T细胞急性淋巴细胞白血病(ALL;T-ALL)/淋巴瘤(LBL)代表着重大的未满足医疗需求。WU-CART-007是一种靶向CD7的、同种异体的、抗自相残杀的CAR-T 细胞产品,由健康供者T细胞制备。WU-CART-007在一项1/2期研究中进行了评估,采用3+3剂量递增设计,随后在复发/难治性T-ALL/LBL中进行队列扩展。患者在标准或增强型淋巴细胞清除化疗后接受1次WU-CART-007输注。主要目标,即表征安全性和评估复合完全缓解率,均已达到。在入组的28例患者中,13例接受了推荐2期剂量(RP2D)900 × 106个WU-CART-007细胞并接受增强型淋巴细胞清除。最常见的治疗相关不良事件是细胞因子释放综合征(88.5%;19.2%为3-4级)。发生了2例1级免疫效应细胞相关神经毒性综合征事件(7.7%)和1例2级急性移植物抗宿主病事件(3.8%)。观察到1例2级免疫效应细胞相关噬血细胞性淋巴组织细胞增多症样综合征。在接受增强型淋巴细胞清除化疗、可在RP2D评估疗效的11例患者中,总缓解率为90.9%,复合完全缓解率为72.7%。WU-CART-007在RP2D下在复发/难治性T-ALL/LBL患者中表现出高缓解率,并有可能提供一种新的治疗选择。该试验已在www.ClinicalTrials.gov注册,注册号为#NCT04984356。
Relapsed/refractory T-cell acute lymphoblastic leukemia (ALL; T-ALL)/lymphoma (LBL) represent a significant unmet medical need. WU-CART-007 is a CD7-targeting, allogeneic, fratricide-resistant chimeric antigen receptor T-cell product generated from healthy donor T cells. WU-CART-007 was evaluated in a phase 1/2 study with a 3+3 dose-escalation design followed by cohort expansion in relapsed/refractory T-ALL/LBL. Patients received 1 infusion of WU-CART-007 after standard or enhanced lymphodepleting chemotherapy. The primary objectives, to characterize safety and assess the composite complete remission rate, were met. Of 28 patients enrolled, 13 received the recommended phase 2 dose (RP2D) of 900 × 106 cells of WU-CART-007 with enhanced lymphodepletion. The most common treatment-related adverse event was cytokine release syndrome (88.5%; 19.2% grade 3-4). Two grade 1 immune effector cell-associated neurotoxicity syndrome events (7.7%) and 1 grade 2 acute graft-versus-host disease event occurred (3.8%). One grade 2 immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome was observed. Among the 11 patients evaluable for response at the RP2D who received enhanced lymphodepleting chemotherapy, the overall response rate was 90.9%, and the composite complete remission rate was 72.7%. WU-CART-007 at the RP2D demonstrated a high response rate in patients with relapsed/refractory T-ALL/LBL and has the potential to provide a new treatment option. This trial was registered at www.ClinicalTrials.gov as #NCT04984356.
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