单细胞追踪揭示黑色素瘤 TIL 治疗过程中肿瘤反应性 T 细胞的可塑性
Single-cell tracking reveals tumor-reactive T cell plasticity during melanoma TIL therapy.
TIL(肿瘤浸润淋巴细胞)过继细胞治疗可在转移性黑色素瘤中诱导持久缓解,然而在体外扩增过程中及回输后,调控肿瘤反应性T细胞命运的克隆和转录动态仍知之甚少。
英文原题:FDA Approval Summary: Lifileucel for Unresectable or Metastatic Melanoma Previously Treated with an Anti-PD-1-Based Immunotherapy.
在作为获批依据的II期单臂试验Study C-144-01中,主要疗效队列内接受FDA批准剂量范围(7.5 × 109至72 × 109个活细胞,n = 73)lifileucel治疗的患者客观缓解率为31.5%(95% CI,21.1%-43.4%),包括3例(4.1%)完全缓解和20例(27.4%)部分缓解。
2024年2月16日,FDA加速批准lifileucel(Amtagvi,Iovance Biotherapeutics, Inc.)用于治疗既往接受过PD-1阻断抗体治疗、且若BRAF V600突变阳性则接受过BRAF抑制剂联合或不联合MEK抑制剂治疗的不可切除或转移性黑色素瘤成人患者。Lifileucel是FDA批准的首个肿瘤来源T细胞疗法。在作为获批依据的II期单臂试验Study C-144-01中,主要疗效队列中接受FDA批准剂量范围(7.5 × 109至72 × 109个活细胞,n = 73)内lifileucel治疗的患者客观缓解率为31.5%(95% CI,21.1%-43.4%),包括3例(4.1%)完全缓解和20例(27.4%)部分缓解。中位缓解持续时间未达到(95% CI,4.1个月-未达到)。在缓解者(n = 23)中,分别有56.5%、47.8%和43.5%在6、9和12个月时维持持久缓解。在Study C-144-01主要队列和支持队列中所有接受lifileucel治疗的患者(n = 156)中,95.5%的患者发生至少1起3级治疗中出现的不良事件,87.8%发生至少1起4级治疗中出现的不良事件。Lifileucel说明书包含关于治疗相关死亡、持续性严重血细胞减少、严重感染、心肺功能损害和肾功能损害的黑框警告。
On February 16, 2024, the FDA granted accelerated approval to lifileucel (Amtagvi, Iovance Biotherapeutics, Inc.) indicated for the treatment of adult patients with unresectable or metastatic melanoma previously treated with a PD-1-blocking antibody and, if BRAF V600 mutation positive, a BRAF inhibitor with or without an MEK inhibitor. Lifileucel is the first tumor-derived T-cell therapy approved by the FDA. In the phase II single-arm trial, Study C-144-01, that served as the basis for approval, the objective response rate among patients treated with lifileucel within FDA-approved dose range (7.5 × 109 to 72 × 109 viable cells, n = 73) in the primary efficacy cohort was 31.5% (95% confidence interval, 21.1%-43.4%), including three (4.1%) complete responses and 20 (27.4%) partial responses. The median duration of response was not reached (95% confidence interval, 4.1 months-not reached). Among the responders (n = 23), 56.5%, 47.8%, and 43.5% maintained durable responses at 6, 9, and 12 months, respectively. Among all patients who received lifileucel (n = 156) in the primary and supportive cohorts of Study C-144-01, 95.5% of patients experienced at least one Grade 3 treatment-emergent adverse event and 87.8% experienced at least one Grade 4 treatment-emergent adverse event. Lifileucel labeling includes a Boxed Warning for treatment-related mortality, prolonged severe cytopenia, severe infection, cardiopulmonary impairment, and renal impairment.
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