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:Case Report: Durable response to tumor-infiltrating lymphocyte therapy in a patient with metastatic melanoma and chronic lymphocytic leukemia/small lymphocytic lymphoma.
该输注产品与9个月随访时采集的外周血单个核细胞之间的TCR序列高度重叠(60%),这证明了TIL在该患者体内的长期存续。
TIL(肿瘤浸润淋巴细胞)疗法已显示出对免疫检查点治疗耐药/难治性晚期黑色素瘤患者的疗效。然而,在同时患有慢性淋巴细胞白血病(CLL)/小淋巴细胞淋巴瘤(SLL)和晚期黑色素瘤的患者中,其安全性和有效性仍有待确定。本病例首次证明,采用淋巴细胞清除性化疗后给予未经选择的TIL和白介素-2,成功治疗了一名同时患有CLL/SLL的转移性黑色素瘤患者。该治疗是安全的,未观察到新的毒性反应,产生了持久的影像学部分缓解和分子学缓解,可检测的循环肿瘤DNA完全清除。用于生成TIL产品的 harvested 黑色素瘤微环境中含有大量CD8 + TCF1 + 和CD8 + CD69 + T细胞,CD8 + T细胞与CD11c髓系网络存在空间共聚集。尽管含有SLL沉积,harvested 黑色素瘤仍产生了以CD8 + T细胞为主的肿瘤反应性TIL输注产品,其中含有干细胞样CD39 neg CD69 neg CD8 + T细胞。该输注产品与9个月随访时采集的外周血单个核细胞之间的TCR序列高度重叠(60%),证明TIL在该患者体内长期持续存在。
Tumor-infiltrating lymphocyte (TIL) therapy has demonstrated efficacy for the treatment of immune checkpoint therapy-resistant/refractory advanced melanoma patients. However, its safety and efficacy remain to be determined among patients with concurrent chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) and advanced melanoma. This case is the first to demonstrate the successful treatment of a metastatic melanoma patient with concurrent CLL/SLL using lymphodepleting chemotherapy followed by unselected TIL and interleukin-2. The treatment was safe with no new toxicities observed, resulting in a durable radiological partial response and molecular response with the complete clearance of detectable circulating tumor DNA. The microenvironment of the harvested melanoma used to generate the TIL product contained an abundance of CD8 + TCF1 + and CD8 + CD69 + T cells, spatial co-clustering of CD8 + T cells with CD11c myeloid networks. Despite containing SLL deposits, the harvested melanoma produced a CD8 + T cell-predominant tumor-reactive TIL infusion product containing stem-like CD39 neg CD69 neg CD8 + T cells. A strong overlap (60%) in the TCR sequences between this infusion product and peripheral blood mononuclear cells collected at the 9-month follow-up visit was evidence of long-term persistence of TIL in this patient.
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