抗 CD22/CD19 CAR-T 细胞疗法 CART2219.1 在成人和儿童复发/难治性 B-ALL 中的 I/II 期试验
A Phase I/II Trial of Anti-CD22/CD19 CAR-T Cell Therapy, CART2219.1, in Adult and Pediatric Relapsed/Refractory B-ALL.
在一项多中心I/II期试验中,所有患者(n=11;7名儿童,4名成人)在第28天均达到完全缓解(91%为微小残留病阴性)。
英文原题:Vaccine-educated T cells and a CD123 bispecific T-cell engager for treatment of acute myeloid leukemia.
T细胞衔接器(TCE)疗法在血液系统恶性肿瘤患者中已显示出显著的治疗疗效。
T细胞衔接器(TCE)疗法在血液系统恶性肿瘤患者中已显示出显著的治疗疗效。持久的缓解与T细胞克隆型扩增相关。我们假设,将能够诱导白血病特异性T细胞扩增的疫苗教育T细胞(veTcs)与TCE联合使用,可通过更强地诱导肿瘤特异性免疫来增强TCE的疗效。在本研究中,我们在小鼠异种移植模型中探索了一种靶向髓系白血病细胞上人CD123的TCE,并与由自体树突状细胞/急性髓系白血病融合疫苗刺激的T细胞联合使用。我们证明,CD123 TCE(SAR440234)与veTcs联合可在体外增强肿瘤特异性T细胞免疫并增强抗白血病效应。此外,在体内,SAR440234与veTca联合治疗完全清除了白血病植入,优于SAR440234与未教育T细胞的联合治疗。这一效应与细胞毒性T细胞亚群增加和克隆型扩增相关。因此,TCE与veTcs过继性T细胞转移的联合是一种新方法,值得在临床试验中进一步研究。
T-cell engager (TCE) therapy has demonstrated significant therapeutic efficacy in patients with hematologic malignancies. Durable responses have been linked with T-cell clonotypic expansion. We hypothesized that combining vaccine-educated T cells (veTcs) that induce the expansion of leukemia-specific T cells would enhance efficacy of TCE through greater induction of tumor-specific immunity. In this study, we explored a TCE targeting human CD123 on myeloid leukemia cells in conjunction with T cells stimulated by an autologous dendritic cell/acute myeloid leukemia fusion vaccine in a murine xenograft model. We demonstrated that the combination of CD123 TCE (SAR440234) and veTcs boosted tumor-specific T-cell immunity and enhanced antileukemia effect in vitro. Furthermore, in vivo SAR440234 and veTca combination treatment fully eradicated leukemia engraftment outperforming SAR440234 in conjunction with uneducated T cells. This effect was associated with an increase in cytotoxic T-cell subsets and clonotypic expansion. Thus, the combination of TCE with adoptive T-cell transfer of veTcs is a novel approach that merits further investigation in clinical trials.
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