不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel:ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Using the iCasp9 suicide strategy to control the growth and function of genome-edited B cells with redirected antigen specificity.
Using the iCasp9 suicide strategy to control the growth and function of genome-edited B cells with redirected antigen specificity.
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B细胞可能是有前景的免疫治疗“药物细胞”,但通过基因组编辑重定向其特异性的报道尚未包含安全性策略。为解决细胞治疗潜在的并发症,对整合安全性开关的需求日益增长。这在B细胞中尤为相关,因为B细胞易发生恶性转化。
我们在B细胞中评估了插入诱导型caspase-9(iCasp9)自杀基因,同时联合报告基因或针对肿瘤抗原的单链免疫球蛋白盒的表达效果。
我们证明,对IgH基因座进行单次编辑即可同时表达iCasp9和劫持抗原特异性的盒,同时保留B细胞功能。在原发性及恶性淋巴瘤B细胞中,使用药物AP1903激活iCasp9可在体外以及移植到免疫缺陷动物的已建立肿瘤中迅速诱导编辑细胞凋亡。尽管AP1903处理强烈抑制了编辑细胞的存活,但随后总是出现对iCasp9和治疗性抗体盒表达均降低的耐药细胞的选择。
因此,在过继免疫治疗方案中,iCasp9/AP1903安全性开关可作为有效的辅助治疗,以及调节治疗分子输注的变阻器。
B cells could be effective immunotherapeutic "drug cells," but reports of genomic editing to redirect their specificity have not included safety strategies. To address the potential complications of cell therapy, there is a growing demand for integrated safety switches. This is particularly pertinent in the case of B cells, which are prone to malignant transformation.
We evaluated in B cells the efficacy of inserting the inducible caspase-9 (iCasp9) suicide gene, together with either a reporter gene or a single-chain immunoglobulin cassette specific for a tumor antigen.
We demonstrate that a single edit of the IgH locus enables the expression of both iCasp9 and the cassette hijacking antigen specificity, while preserving B cell functionality. In both primary and malignant lymphoma B cells, activation of iCasp9 using the drug AP1903 readily induced apoptosis of edited cells, both in vitro and in established tumors grafted to immunodeficient animals.
Although AP1903 treatment strongly curbed edited cell survival, this was constantly followed by the selection of resistant cells with lowered expression of both iCasp9 and the therapeutic antibody cassette.
Therefore, in adoptive immunotherapy protocols, the iCasp9/AP1903 safety switch could stand as an efficient neoadjuvant therapy, as well as a rheostat to modulate the infusion of a therapeutic molecule.
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