肿瘤细胞治疗研究
英文原题:Ten-year experience of CD22 CAR T cells for children and young adults with B-cell acute lymphoblastic leukemia.
Ten-year experience of CD22 CAR T cells for children and young adults with B-cell acute lymphoblastic leukemia.
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2014年,首例患者接受了CD22嵌合抗原受体(CAR)T细胞产品。作为最早靶向CD19以外抗原的方法之一,该试验解决了一个未满足的需求,同时在其10年历程中提供了关于CAR-T 细胞疗效、生产变更影响以及炎症毒性管理的见解。本最终章节对汇总发现进行了全面回顾。在78例接受输注的B细胞急性淋巴细胞白血病患者中,66例(84.6%)患者观察到细胞因子释放综合征,而28例(35.9%)发生免疫效应细胞相关噬血细胞性淋巴组织细胞增生症样综合征(IEC-HS),18例(23.1%)发生可逆性神经毒性。到第28天,54例(70.1%)患者达到完全缓解,其中45例(83.3%)为可测量残留病阴性。中位总生存期为13.6个月,中位无复发生存期为6.1个月。药代动力学显示,CAR-T 细胞扩增峰值出现在中位14天(范围,12-50),且不随剂量变化。有趣的是,毒性、CAR-T 细胞扩增和疾病缓解均与基线疾病负荷不相关。
此外,尽管针对该构建体减轻IEC-HS严重程度的早期干预方法看似有前景,但仍需进一步研究。鉴于靶向CD22的至关重要性,这一经验为靶向CD22的新方法奠定了基础,同时为双靶向方法提供了持续支持,并为减轻毒性提供了见解。该试验已在www.ClinicalTrials.gov注册,注册号为NCT02315612。
In 2014, the first patient received a CD22 chimeric antigen receptor (CAR) T-cell product. As one of the earliest approaches targeting an antigen other than CD19, this trial addressed an unmet need while providing insights into CAR T-cell efficacy, impact of manufacturing changes, and management of inflammatory toxicities over its 10-year span. This final chapter provides a comprehensive review of the collective findings. Across 78 patients with B-cell acute lymphoblastic leukemia who received infusion, cytokine release syndrome was observed in 66 (84. 6%) patients, whereas 28 (35.
9%) had immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome (IEC-HS), and 18 (23. 1%) had reversible neurotoxicity. Complete response was achieved in 54 (70. 1%) patients by day 28, of whom 45 (83. 3%) were measurable residual disease negative. Median overall survival was 13.
6 months, and median relapse-free survival was 6. 1 months. Pharmacokinetics revealed peak CAR T-cell expansion at a median of 14 days (range, 12-50), with no variation by dose. Interestingly, toxicities, CAR T-cell expansion, and disease response did not correlate with baseline disease burden.
Additionally, although early intervention approaches to mitigate IEC-HS severity for this construct appeared promising, further study is needed. Given the critical importance of CD22 targeting, this experience serves as a foundation for new approaches targeting CD22 while providing ongoing support for dual-targeting approaches and insights into toxicity mitigation. This trial was registered at www. ClinicalTrials. gov as NCT02315612.
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