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:Bicistronic CAR T-cells Against CD70 & Active Integrin β2 Overcome Antigen Heterogeneity and Preserve Safety in Acute Myeloid Leukemia.
这些发现共同表明,一种有前景且可临床转化的急性髓系白血病治疗方法,且不伴随该病其他主要 CAR-T 靶点相关的显著毒性风险。
急性髓系白血病(AML)的细胞表面抗原具有显著异质性,且与健康造血细胞存在重叠,这对开发能够避免靶向肿瘤外正常组织毒性的AML嵌合抗原受体(CAR)T细胞构成重大障碍。本研究开发了同时靶向CD70和整合素β2活化构象(aITGB2)的双抗原CAR-T;既往研究提示两者均是有前景的AML靶点,且在肿瘤外组织中的表达较少。研究显示,对这两种抗原采用“或”门控策略可显著扩大可靶向的AML原始细胞比例;其中采用了一种新型离体共培养方法,以在冻融循环后恢复细胞表面蛋白稳态。研究者测试了具有不同共刺激结构域组合的双靶向CAR-T构建体,并筛选出在体外针对AML细胞系及患者来源异种移植模型具有更强抗肿瘤细胞毒性的构建体。在AML异质性小鼠模型中,双靶向CAR也显著改善了体内肿瘤清除和生存。最后,研究显示该双靶向CAR不会增加肿瘤外毒性,尤其不会增强对造血干细胞和祖细胞的毒性。总之,这些发现展示了一种有望转化至临床的AML治疗策略,并可避免该疾病其他主要CAR-T靶点所伴随的显著毒性风险。
The surface antigen landscape of acute myeloid leukemia (AML) displays significant heterogeneity and overlap with healthy hematopoietic cells. This imparts a substantial hurdle to the development of AML-targeting chimeric antigen receptor (CAR) T-cells that can avoid on-target, off-tumor toxicity. Here, we develop a dual-antigen targeting CAR-T against CD70 and the active conformation of integrin 2 (aITGB2), each previously reported as promising AML targets due to minimal off-tumor expression. We show an OR-gated approach for these antigens significantly increases the proportion of AML blasts that can be targeted, in part using a novel ex vivo co-culture method to restore surface protein homeostasis following a freeze-thaw cycle. We test dual-targeting CAR-T constructs with different combinations of costimulatory domains, identifying constructs with superior anti-tumor cytotoxicity in vitro against AML cell line and patient derived xenograft models. We further show significantly improved in vivo tumor clearance and survival for a dual targeting CAR in murine models of AML tumor heterogeneity. Finally, we show that this dual-targeting CAR does not increase off-tumor toxicity, especially against hematopoietic stem and progenitor cells. Together, these findings demonstrate a promising clinically-translatable approach for the treatment of AML without the notable toxicity liabilities associated with other leading CAR-T targets for this disease.
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