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:CD70-Targeting CAR NK Cells Overcome BCMA Downregulation and Improve Survival in High-risk Multiple Myeloma Models.
这些结果确立了 CD70 作为高危多发性骨髓瘤有前景的治疗靶点,尤其适用于 BCMA 靶向治疗后复发的患者,并为正在进行的靶向 CD70 的 CAR NK 细胞 I/II 期临床试验(NCT05092451)提供了临床前支持。
CD70在包括多发性骨髓瘤在内的多种癌症中高表达。研究者在两个多发性骨髓瘤患者队列中发现,CD70在若干高危疾病亚类中表达升高,并与生存不良相关;单细胞RNA测序、流式细胞术和免疫组化均验证了这些发现。研究还证明,可利用表达嵌合抗原受体(CAR)的NK细胞靶向骨髓瘤CD70:该CAR包含CD70的对应受体CD27和IL-15(CAR27/IL-15)。CAR27/IL-15 NK细胞对CD70阳性多发性骨髓瘤细胞具有强效体内外细胞毒性,效果与CAR27/IL-15 T细胞相当;在BCMA敲除模型中仍保持活性。综上,这些结果确认CD70是高危多发性骨髓瘤一个有前景的治疗靶点,尤其适用于BCMA靶向治疗后复发的患者,并为正在进行的靶向CD70 CAR-NK细胞I/II期临床试验(NCT05092451)提供临床前依据。意义:研究显示,高危多发性骨髓瘤患者及具有t(4;14)易位的患者CD70表达升高。靶向CD70的CAR-NK细胞对CD70阳性多发性骨髓瘤细胞具有强效细胞毒性,并显著延长多发性骨髓瘤异种移植小鼠的生存,即使肿瘤不表达BCMA亦然。参见Benson Jr和Caligiuri的相关评论,第166页。
UNLABELLED: CD70 is highly expressed in many cancers, including multiple myeloma. We show in two cohorts of patients with multiple myeloma that CD70 is elevated in several high-risk disease categories and correlates with poor survival. These findings were validated using single-cell RNA sequencing, flow cytometry, and IHC. Moreover, we demonstrate the feasibility of targeting CD70 in myeloma using NK cells engineered with a chimeric antigen receptor (CAR) incorporating the CD70 cognate receptor CD27 and IL-15 (CAR27/IL-15). CAR27/IL-15 NK cells exerted potent in vitro and in vivo cytotoxicity against CD70+ multiple myeloma cells, comparable with CAR27/IL-15 T cells, and remained effective in BCMA knockout models. Collectively, these results establish CD70 as a promising therapeutic target for high-risk multiple myeloma, particularly for patients who relapse after BCMA-directed therapy, providing preclinical support for the ongoing phase I/II clinical trial of CD70-targeting CAR NK cells (NCT05092451). SIGNIFICANCE: We demonstrate that CD70 expression is elevated in patients with high-risk multiple myeloma and in patients with t(4;14) translocation. CD70-targeting CAR NK cells exhibit potent cytotoxicity against CD70+ multiple myeloma cells and significantly improve survival in xenograft mouse models of multiple myeloma, even in the absence of BCMA expression. See related commentary by Benson Jr and Caligiuri, p. 166.
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