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:Dual-targeted ping-pong CAR T cells: Leveraging peripheral expansion to improve solid tumor immunotherapy.
我们证明双靶向CAR T细胞可增强外周扩增和抗肿瘤疗效,为改善接受针对实体瘤的临床CAR T产品治疗的患者结局提供了一种策略。
B细胞恶性肿瘤中对CD19靶向CAR T细胞治疗的临床反应与外周血中CAR T细胞的强劲扩增密切相关。相比之下,靶向实体瘤的CAR T细胞在外周无法遇到同源抗原,导致扩增有限且峰值浓度低于治疗水平。为克服这一问题,我们设计了双靶向和双共刺激CAR T细胞(CD19/28-M5BB),其可识别CD19+ B细胞,从而促进外周扩增并增加可用于肿瘤浸润的实体瘤靶向CAR T细胞池,且无需淋巴清除。在具有免疫能力的C57BL/6小鼠胰腺导管腺癌和黑色素瘤模型中,与单抗原靶向CAR T细胞相比,这些双靶向CAR T细胞表现出增强的外周扩增、改善的抗肿瘤疗效和延长的生存期,且未增加功能障碍或毒性。我们通过建立外周存在CD19+ B细胞的胰腺/异种移植模型,将研究发现转化至人类CAR T细胞,并再次证明与单抗原靶向CAR T细胞相比,双CAR T细胞治疗显示出显著增强的肿瘤清除和生存期。总之,我们证明双靶向CAR T细胞可增强外周扩增和抗肿瘤疗效,为改善接受靶向实体瘤的临床CAR T产品治疗的患者预后提供了一种策略。
Clinical responses to CD19-directed CAR T cell therapy in B cell malignancies are strongly associated with robust CAR T cell expansion in the peripheral blood. In contrast, CAR T cells targeting solid tumors do not encounter cognate antigen in the periphery, resulting in limited expansion and subtherapeutic peak concentrations. To overcome this, we engineered dual-targeted and dual-costimulated CAR T cells (CD19/28 -M5BB ) that recognize CD19+ B cells, thereby promoting peripheral expansion and increasing the pool of solid tumor-directed CAR T cells available for tumor infiltration without the need for lymphodepletion. In immunocompetent C57BL/6 mouse models of pancreatic ductal adenocarcinoma and melanoma, these dual-targeted CAR T cells demonstrated enhanced peripheral expansion, improved anti-tumor efficacy, and increased survival without added dysfunction or toxicity compared to single antigen-targeted CAR T cells. We translated our findings to human CAR T cells by developing a pancreatic/xenograft model with CD19 + B cells in the periphery and again demonstrated that treatment with dual CAR T cells showed significantly enhanced tumor clearance and survival compared to single antigen-targeted CAR T cells. In conclusion, we demonstrate that dual-targeted CAR T cells boost peripheral expansion, and anti-tumor efficacy, providing a strategy for enhancing outcomes for patients treated with clinical CAR T products targeting solid tumors.
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