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:Co-expression of an adapter CAR retains efficacy of CAR T cells after single and dual antigen loss in lymphoma.
CAR-T 细胞疗法对许多 B 细胞恶性肿瘤患者有效,但抗原逃逸是导致疗效减弱或丧失的主要耐药机制。
CAR-T细胞疗法对许多B细胞恶性肿瘤患者有效,但抗原逃逸是导致疗效减弱或丧失的主要耐药机制。为应对这一问题,研究者开发了常规与适配器双重CAR-T(ConvAD CAR-T)细胞,以增强抗淋巴瘤活性。该细胞共同表达常规抗原特异性CAR和P329G适配器CAR,后者利用Fc区突变抗体重新定向细胞。ConvAD CAR-T细胞可针对常规CAR的原发淋巴瘤抗原发挥强效功能;若发生抗原逃逸,还可通过靶标特异性适配器灵活转向其他靶点。研究显示,ConvAD CAR-T细胞具有双重作用机制,既可由常规CAR直接结合靶标,也可通过适配器结合,从而增强多特异性抗淋巴瘤靶向。在体内外实验中,联合靶向ROR1、CD19和CD20的ConvAD CAR-T细胞可在多种模型中阻止淋巴瘤生长,涵盖抗原持续表达、单一抗原丢失及双抗原丢失等情形;其表现优于单抗原特异性CAR-T和双特异性CAR-T细胞。ConvAD CAR平台提供了有效的多抗原靶向策略,可满足临床需求并对抗抗原逃逸。
CAR-T cell therapy is effective in many patients suffering from B cell malignancies, yet antigen escape is a major resistance mechanism by which efficacy can be diminished or lost. To counter this, we enhance anti-lymphoma CAR-T cells by generating conventional and adapter dual (ConvAD) CAR-T cells, which co-express a conventional antigen-specific CAR and the P329G adapter CAR that leverages Fc-mutated antibodies for redirection. ConvAD CAR-T cells display robust functionality against the primary lymphoma antigen of the conventional CAR while providing flexible redirection to additional targets via target-specific adapters in the event of antigen escape. We demonstrate the bimodal activity of ConvAD CAR-T cells acting through direct engagement of the conventional CAR as well as through binding of adapters, resulting in enhanced multispecific anti-lymphoma targeting. In vitro and in vivo, ConvAD CAR-T cells targeting combinations of ROR1, CD19, and CD20 prevent lymphoma outgrowth across models of stable antigen expression as well as single- or dual-antigen loss, and benchmark superior to both single-antigen specific and bispecific CAR-T cells. The ConvAD CAR platform thus addresses a medical need by offering an effective strategy for multi-antigen targeting, counteracting antigen escape.
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