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:Universal off-the-shelf combination immunotherapy using oncolytic viruses to redirect T cell engagers to target solid tumors.
我们的研究结果表明,OV与TCEs的联合提供了一种有前景的策略,可驱动针对实体瘤的抗肿瘤免疫应答。该方法代表了一种新颖且通用的平台,目前正处于将TCE疗法与溶瘤病毒疗法联合的1期临床试验中,克服了抗原异质性和免疫屏障,从而实现实体瘤的有效治疗。
双特异性T细胞衔接器(BiTE),如blinatumomab,已在治疗B细胞急性淋巴细胞白血病和非霍奇金淋巴瘤等血液系统恶性肿瘤中展现出显著的临床成功。然而,BiTE在实体瘤中的应用已被证明具有挑战性,主要原因是缺乏可靶向的肿瘤抗原以及肿瘤微环境的免疫“冷”特性,这限制了免疫系统的激活。
我们开发了一种新型溶瘤病毒(OV)平台,通过工程化改造嵌合痘苗病毒,使其在感染肿瘤细胞表面表达截短的非信号传导 CD19 抗原(CD19t)或截短的 B 细胞成熟抗原(BCMAt)。在此,我们推进了一种组合平台,利用 OV 将 CD19 靶向或 BCMA 靶向的 T 细胞衔接器(TCEs)重定向,以驱动针对多种实体瘤的抗肿瘤反应。
我们发现,OV感染的肿瘤细胞与TCEs联合使用可显著提高对实体瘤模型的肿瘤细胞杀伤效果,其疗效与CAR-T 细胞相当。该联合策略在体内人肿瘤异种移植模型中增强了抗肿瘤反应,并比任一单一疗法更有效地清除了实体瘤细胞。我们的研究强调,OVs与临床已批准的TCEs联合是一种易于转化、不限肿瘤类型、即用型的策略,可有效靶向实体瘤。
BACKGROUND: Bispecific T cell engager (BiTE), such as blinatumomab, has demonstrated significant clinical success in treating hematological malignancies like B cell acute lymphoblastic leukemia and non-Hodgkin's lymphoma. However, the application of BiTEs in solid tumors has proven challenging, primarily due to the lack of targetable tumor antigens and the immunologically "cold" nature of the tumor microenvironment, which limits immune system activation. METHODS: We developed a novel oncolytic virus (OV) platform by engineering a chimeric vaccinia virus to express either a truncated non-signaling CD19 antigen (CD19t) or truncated B cell maturation antigen (BCMAt) on the surface of infected tumor cells. Here, we advance a combinatorial platform using an OV to redirect CD19-targeted or BCMA-targeted T cell engagers (TCEs) to drive antitumor responses against multiple solid tumors. RESULTS: We found that OV-infected tumor cells in combination with TCEs significantly improved tumor cell killing against solid tumor models, with efficacy comparable to that of chimeric antigen receptor T cells. This combination approach enhanced antitumor responses using in vivo human tumor xenograft models and promoted more effective elimination of solid tumor cells than either therapy alone. Our studies highlight OVs combined with clinically approved TCEs as a readily translatable, tumor-agnostic, off-the-shelf strategy to effectively target solid tumors. CONCLUSIONS: Our findings demonstrate that the combination of OV and TCEs offers a promising strategy to drive antitumor immune responses against solid tumors. This approach represents a novel and universal platform currently in phase 1 clinical trial combining TCE therapy with oncolytic virotherapy, overcoming antigen heterogeneity and immunological barriers for the effective treatment of solid tumors.
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