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:Platelet-engineered CAR-T cells as adjuvant therapy after cancer surgery.
Platelet-engineered CAR-T cells as adjuvant therapy after cancer surgery.
手术仍是许多实体瘤的主要治疗手段,但肿瘤复发频繁发生。
手术仍是多种实体瘤的主要治疗手段,但肿瘤复发频繁发生。辅助治疗可降低复发风险并改善手术预后。嵌合抗原受体(CAR)-T细胞疗法可作为替代性辅助治疗,用于清除残留癌细胞并预防肿瘤复发。然而,CAR-T的全身给药常导致肿瘤浸润不足以及对正常器官的副作用。鉴于血小板可优先聚集于术后创面,我们提出将血小板与CAR-T细胞偶联,可能增强CAR-T细胞在实体瘤切除后手术床内的聚集。在本研究中,我们通过点击化学将血小板与B7-H3.CAR-T细胞偶联。在术后人胰腺癌小鼠模型中,与CAR-T细胞相比,血小板-CAR-T细胞显示出增强的肿瘤浸润和升高的抗肿瘤细胞因子水平,从而对肿瘤复发产生更优的抑制效果。此外,在术后三阴性乳腺癌(TNBC)模型中,血小板-CAR-T细胞在抑制转移和延长小鼠生存时间方面显示出增强的疗效。机制研究揭示,血小板活化可改善CAR-T细胞活性和持久性,表现为与T细胞浸润相关基因的上调和与T细胞耗竭相关基因的下调。最后,我们在术后患者来源异种移植TNBC人源化小鼠模型中进一步验证了血小板-CAR-T的生物安全性特征和疗效。结果表明,经血小板工程强化的CAR-T细胞是一种有前景的对抗术后肿瘤复发的辅助治疗。
Surgery remains the mainstay treatment for many kinds of solid tumors, while tumor recurrence frequently occurs. Adjuvant therapy can reduce the risk of recurrence and improve the prognosis of surgery. Chimeric antigen receptor (CAR)-T cell therapy can be leveraged as an alternative adjuvant therapy to clear residual cancer cells and prevent tumor recurrence. However, systemic administration of CAR-T often results in insufficient tumor infiltration and side effects to normal organs. Given that platelets can preferentially accumulate at postsurgical wounds, we proposed that conjugating platelets to CAR-T cells may enhance the accumulation of the CAR-T cells within the surgical bed after the resection of solid tumors. In this study, we conjugated platelets to B7-H3.CAR-T cells via click chemistry. In postsurgical human pancreatic cancer mouse models, platelet-CAR-T cells showed enhanced tumor infiltration and elevated antitumor cytokine levels, resulting in superior suppression effects on tumor recurrence, compared with CAR-T cells. Additionally, platelet-CAR-T cells showed enhanced efficacy in inhibiting metastasis and prolonging the survival time of the mice in postsurgical triple-negative breast cancer (TNBC) models. Mechanistic studies revealed that platelet activation could improve the CAR-T cell activity and persistence, as evidenced by an upregulation of genes associated with T cell infiltration and a downregulation of genes related to T cell exhaustion. Finally, we further validated the biosafety profile and efficacy of platelet-CAR-T in a postsurgical patient-derived xenograft TNBC-bearing humanized mouse model. The results suggested that the CAR-T cell strengthened by platelet engineering is a promising adjuvant therapy against postsurgical tumor recurrence.
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