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:Preclinical development and a phase 1 trial of IMC001, an EpCAM-targeted CAR-T cell therapy, in patients with advanced gastric cancer.
Preclinical development and a phase 1 trial of IMC001, an EpCAM-targeted CAR-T cell therapy, in patients with advanced gastric cancer.
这些发现表明 IMC001 在晚期胃癌中具有可接受的安全性和有前景的疗效,支持在难治性胃癌患者中进一步开展临床开发。
针对晚期胃癌(GC)开发了自体 EpCAM 靶向 CAR-T 细胞疗法 IMC001。本研究在临床前模型及一项 I 期剂量递增/扩展试验中,评估 IMC001 的特异性、疗效和安全性;试验纳入既往至少接受两线治疗失败的患者。IMC001 可特异性识别 EpCAM,并对 EpCAM⁺ 肿瘤细胞、异种移植模型和患者来源类器官表现出强效抗肿瘤活性。2021 年 8 月至 2023 年 5 月,12 例晚期 GC 患者接受 IMC001。所有患者均发生 3 或 4 级治疗相关不良事件,主要为淋巴清除治疗相关淋巴细胞减少;未发生治疗相关死亡。5 例患者发生细胞因子释放综合征(其中 3 例为 3–4 级),2 例发生免疫相关性肝炎(中剂量组 1 例为 3 级,高剂量组 1 例为 4 级)。低剂量组部分缓解率为 33.3%(1/3),中剂量组为 40%(2/5);客观缓解率为 30%,疾病控制率为 70%。中位无进展生存期和总生存期分别为 4.5 个月和 8.4 个月。1 例患者于第 27 周接受转化手术,输注后 31.5 个月仍存活。结果显示 IMC001 在晚期 GC 中具有可接受的安全性和有前景的疗效,支持进一步用于难治性 GC 患者的临床开发。
Autologous EpCAM-targeted CAR-T cell therapy (IMC001) was developed for advanced gastric cancer (GC). This study evaluated the specificity, efficacy, and safety of IMC001 in preclinical models and a phase 1 dose-escalation/expansion trial in patients who had failed at least two lines of therapy. IMC001 specifically recognized EpCAM and exhibited potent anti-tumor activity in EpCAM + tumor cells, xenograft models, and patient-derived organoids. From August 2021 to May 2023, 12 advanced GC patients received IMC001. All patients experienced grade 3 or 4 treatment-related adverse events, mainly lymphopenia related to lymphodepletion, with no treatment-related deaths. Five patients experienced cytokine release syndrome (n = 3, grade 3-4) and two patients experienced immune-related hepatitis (n = 1, grade 3 in middle-dose group; n = 1, grade 4 in high-dose group). Partial responses were observed in 33.3% (1/3) of low-dose patients and 40% (2/5) of middle-dose patients, achieving an objective response rate of 30% and a disease control rate of 70%. Median progression-free survival and overall survival were 4.5 and 8.4 months, respectively. One patient underwent conversion surgery at week 27 and remains alive 31.5 months post-infusion. These findings demonstrate an acceptable safety profile and promising efficacy of IMC001 in advanced GC, supporting further clinical development for refractory GC patients.
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