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:Secretion of a VEGF-Blocking scFv Enhances CAR T-cell Potency.
Secretion of a VEGF-Blocking scFv Enhances CAR T-cell Potency.
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嵌合抗原受体(CAR)T细胞疗法是治疗B细胞恶性肿瘤的有效策略,但其治疗实体瘤的疗效仍有限。靶向VEGF的药物可通过作用于异常肿瘤血管发挥抗肿瘤作用,但全身阻断VEGF相关的毒性限制了其最大治疗获益。越来越多的证据表明,VEGF参与肿瘤微环境的免疫抑制,包括直接诱导T细胞效应功能障碍。
本研究显示,接受FDA批准CAR-T 细胞产品治疗的患者,其CAR-T 细胞表达VEGF信号通路相关分子,且这种表达与患者无应答相关。为克服推测由VEGF诱导的CAR-T 细胞功能障碍并实现局部VEGF阻断,我们构建了可分泌靶向VEGF的单链可变片段的CAR-T 细胞,以在肿瘤微环境内阻断T细胞和肿瘤来源的VEGF。这些CAR-T 细胞可强效抑制体外VEGF信号和血管生成,并在不同抗原及实体瘤背景下增强活化、细胞毒性、增殖及效应功能。在免疫缺陷小鼠的卵巢癌和肺癌转移瘤及原位瘤模型中,分泌抗VEGF单链可变片段的CAR-T 细胞改善了肿瘤控制。这些结果提示,CAR-T 细胞分泌VEGF阻断剂可增强CAR-T 细胞性能,在避免全身毒性的同时抑制VEGF,值得进一步开发。
Chimeric antigen receptor (CAR) T-cell therapy is an effective treatment strategy for B-cell malignancies; however, its efficacy in solid tumors remains limited. VEGF-targeted drugs are used as antitumor agents to target abnormal tumor vasculature; however, toxicities associated with systemic VEGF blockade limit their maximal therapeutic benefit. Increasing evidence suggests a role for VEGF in the immunosuppressive tumor microenvironment, including through direct induction of T cell-effector dysfunction. In this study, we show that CAR T cells from patients treated with FDA-approved CAR T-cell products express members of the VEGF signaling pathway, and this expression is correlated with patient nonresponse.
To overcome putative VEGF-induced CAR T-cell dysfunction and deliver local VEGF blockade, we generated CAR T cells that secrete a VEGF-targeting single-chain variable fragment to block T-cell and tumor-derived VEGF within the tumor microenvironment.
These CAR T cells potently inhibited VEGF signaling and angiogenesis in vitro and exhibited enhanced activation, cytotoxicity, proliferation, and effector function across different antigen and solid tumor contexts. VEGF single-chain variable fragment-secreting CAR T cells showed improved tumor control in immunocompromised murine metastatic and orthotopic models of ovarian and lung cancer.
These findings suggest that CAR T cell-secreted VEGF blockade augments CAR T-cell performance, inhibits VEGF without systemic toxicity, and warrants further development.
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