CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Simultaneous secretion of a PD-L1 x 4-1BB bispecific antibody improves antileukemic efficacy of STAb-T cells secreting a CD19-specific T-cell engager.
Simultaneous secretion of a PD-L1 x 4-1BB bispecific antibody improves antileukemic efficacy of STAb-T cells secreting a CD19-specific T-cell engager.
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CAR-T 细胞过继治疗和全身给予双特异性T细胞接合抗体(TCE),在复发/难治性(R/R)B细胞恶性肿瘤治疗中均取得前所未有的成功,但高复发率仍是主要挑战。STAb-T细胞免疫疗法(分泌T细胞重定向双特异性抗体)可同时募集多克隆T细胞并持续释放双特异性抗体,是一种有前景的替代方案。本文介绍STAb-T19疗法的改进方案。该疗法在B-ALL临床前模型中的结局优于CAR-T-19细胞,其基础是同时分泌两种双特异性抗体:CD19×CD3 TCE和PD-L1×4-1BB双特异性抗体。该联合策略旨在通过阻断PD-1/PD-L1轴,并有条件地提供4-1BB共刺激,增强STAb-T19细胞的抗肿瘤效能,确保STAb-T细胞长期持续存在。临床前数据显示,与低剂量单一STAb-T疗法相比,该联合方法提高了细胞毒活性并延长抗白血病疗效。研究结果提示,将PD-L1×4-1BB双特异性抗体整合至STAb-T19疗法中有望最大化治疗效能,为应对B-ALL耐药和复发开辟有前景的新途径。
此外,该策略还可能推动开发治疗血液系统和实体恶性肿瘤的新一代细胞疗法。
Adoptive therapy with CAR-T cells and systemic administration of bispecific T-cell engagers (TCE) have achieved unprecedented success in the treatment of relapsed/refractory (R/R) B-cell malignancies.
However, high relapse rates remain a major challenge. STAb ( S ecretion of T cell-redirecting bispecific Antibodies)-T-cell immunotherapy represents a promising alternative by enabling both polyclonal T-cell recruitment and sustained bispecific antibody release.
Here, we describe an evolution of STAb-T19 therapy, which has demonstrated superior outcomes to those of CAR-T-19 cells in preclinical models of B-ALL, on the basis of the simultaneous secretion of two bispecific antibodies: a CD19 CD3 TCE and a PD-L1 4-1BB bsAb.
The combined approach aims to increase the antitumor efficacy of STAb-T19 cells by blocking the PD-1/PD-L1 axis with conditional 4-1BB costimulation to ensure the long-term persistence of STAb-T cells. Preclinical data show that this combination improves cytotoxic activity and prolongs antileukemic efficacy compared with low-dose single STAb-T therapy.
Our findings suggest that the integration of PD-L1 4-1BB bsAbs into STAb-T19 therapy may maximize efficacy, thereby opening a promising avenue to address resistance and relapse in B-ALL.
Moreover, this approach may pave the way for the development of next-generation cell-based therapies for hematologic and solid malignancies.
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