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:A CD22-specific T-cell receptor enables effective adoptive T-cell therapy for B-cell malignancies.
我们的研究结果提供了强有力的临床前证据,支持 CD22 TCR 疗法作为 CD22low B 细胞恶性肿瘤的有效治疗选择,包括 CD19 CAR T 细胞治疗后复发的患者。
靶向CD19的嵌合抗原受体(CAR)T细胞疗法已成为复发和/或难治性B细胞恶性肿瘤的标准治疗。由于CD19低表达或阴性肿瘤细胞克隆出现,多达30%–60%的患者会复发。尽管已有研究探索CD19/CD22双特异性CAR-T细胞,但其持续存在时间有限,以及CD19和/或CD22抗原下调,仍削弱了其对复发患者的疗效。对CD22表达的全面分析显示,CD22在所有B细胞淋巴瘤和白血病亚组中普遍表达,因此是有价值的免疫治疗靶点。研究者利用具有人类多样化T细胞受体(TCR)库的人源化小鼠模型,鉴定出一种高亲和力TCR,可靶向由HLA-A*02:01呈递的CD22表位。体外实验中,该TCR对CD22阳性细胞系和患者来源的原发肿瘤样本均显示出高度特异性和有效性。重要的是,在识别CD22表面表达较低的细胞方面,CD22 TCR-T细胞优于CD22 CAR-T细胞,其中包括体内接受CD19 T细胞治疗后出现的CD22低表达Nalm6细胞。与CD22 CAR-T细胞不同,CD22 TCR-T细胞还能有效识别主要表达胞内CD22的肿瘤细胞。在Nalm6 B细胞白血病模型中的体内验证也证实,与CD22 CAR-T细胞相比,CD22 TCR-T细胞对CD22低表达细胞具有更强活性。总之,这些发现为CD22 TCR疗法提供了有力的临床前证据,支持其作为CD22低表达B细胞恶性肿瘤的有效治疗选择,包括CD19 CAR-T治疗后复发的患者。
CD19 chimeric antigen receptor (CAR) T-cell therapy has become the standard of care in relapse and/or refractory B-cell malignancies. Up to 30% to 60% of patients experience relapsed disease because of the emergence of CD19low or CD19- tumor cell clones. Although bispecific CD19/CD22 CAR T cells have been explored, limited persistence and antigen downregulation of CD19 and/or CD22 have compromised their efficacy in relapsing patients. A comprehensive analysis of CD22 expression revealed that CD22 is ubiquitously expressed across all subgroups of B-cell lymphomas and B-cell leukemias, establishing CD22 as a valuable immunotherapeutic target. Using a humanized mouse model with a diverse human T-cell receptor (TCR) repertoire, we identified a high-affinity TCR targeting a CD22 epitope presented by HLA-A 02:01. In vitro, this TCR demonstrated high specificity and efficacy in both CD22+ cell lines and primary patient-derived tumor samples. Importantly, CD22 TCR T cells outperformed CD22 CAR T cells in recognizing cells with low CD22 surface expression, including CD22low Nalm6 cells that emerged after in vivo CD19 T-cell treatment. Unlike CD22 CAR T cells, CD22 TCR T cells effectively recognized tumor cells that predominantly express intracellular CD22. Notably, in vivo validation in a Nalm6 B-cell leukemia model confirmed the superior activity of CD22 TCR T cells against CD22low cells compared to CD22 CAR T cells. In conclusion, our findings provide strong preclinical evidence supporting CD22 TCR-based therapy as a potent treatment option for CD22low B-cell malignancies, including patients who relapsed after CD19 CAR T-cell therapy.
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