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:NKTR-255, a polymer-conjugated IL-15, synergizes with CAR-T cell therapy to activate endogenous anti-tumor immunity and improve tumor control.
我们的数据提示,将 NKTR-255 与 CAR-T 疗法联合,是增强 CAR-T 与内源性抗肿瘤免疫、从而促进对侵袭性肿瘤协同控制的一种有前景的策略。
实体瘤中CAR-T细胞持久性差,且在肿瘤微环境内功能丧失,因此疗法尚未显示广泛疗效。此外,实体瘤中多数CAR靶抗原表达异质,可能导致抗原缺失肿瘤逃逸CAR-T杀伤。协同增强CAR-T及内源性抗肿瘤免疫的策略可能遏制肿瘤逃逸,也可能是实现癌症患者持久疗效的关键。NKTR-255是一种聚合物偶联IL-15,半衰期延长,可增强内源性T细胞和NK细胞,也可提高B细胞恶性肿瘤中CD19 CAR-T的活性。然而,NKTR-255能否克服CAR-T在免疫抑制性实体瘤微环境中的功能障碍,以及它与CAR-T联用如何重塑内源性抗肿瘤免疫,尚不清楚。研究采用ROR1阳性肺腺癌自发小鼠模型,显示NKTR-255显著促进肿瘤浸润CAR-T细胞积累、减轻耗竭并改善功能。与单用NKTR-255或CAR-T相比,联合治疗协同增加肿瘤浸润的CD11b⁺细胞毒性NK细胞、活化树突状细胞及内源性肿瘤特异性T细胞;后者维持PD-1⁺Tcf1⁺干样表型。因此,NKTR-255与CAR-T联合治疗可完全清除ROR1阳性肿瘤并显著改善生存;增强的肿瘤控制依赖CAR-T和内源性T细胞两者的活性。总之,NKTR-255联合CAR-T有望同时增强CAR-T和内源性抗肿瘤免疫,从而协同控制侵袭性肿瘤。
CAR-T cells have yet to show widespread efficacy in solid tumors due in part to their poor persistence and loss of function in the tumor microenvironment. Further, heterogenous expression of most CAR target antigens in solid tumors can lead to escape of antigen-null tumors that resist CAR-T killing. Strategies to cooperatively boost both CAR-T and endogenous anti-tumor immunity could curb tumor escape and may be critical for achieving durable efficacy in cancer patients. NKTR-255 is a polymer-conjugated IL-15 with extended half-life that can boost endogenous T and NK cells, as well as CD19 CAR-T activity in B cell malignancies. However, whether NKTR-255 is sufficient to overcome CAR-T dysfunction in the suppressive solid tumor microenvironment, and how NKTR-255 and CAR-Ts together re-shape endogenous anti-tumor immunity, is not known. Using an autochthonous mouse model of ROR1 + lung adenocarcinoma, we show that NKTR-255 significantly boosted accumulation, reduced exhaustion, and improved function of tumor-infiltrating CAR-T cells. Compared with NKTR-255 or CAR-T treatment alone, combination of NKTR-255 and CAR-T therapy synergistically increased tumor-infiltrating CD11b + cytotoxic NK cells, activated dendritic cells, and endogenous tumor-specific T cells that preserved a PD-1 + Tcf1 + stem-like phenotype. Consequently, NKTR-255 and CAR-T combination therapy induced complete elimination of ROR1 + tumor and significantly improved survival, with enhanced tumor control dependent on activity of both CAR-Ts and endogenous T cells. Altogether, our data suggest that combining NKTR-255 with CAR-T therapy is a promising strategy to enhance both CAR-T and endogenous anti-tumor immunity to promote coordinated control of aggressive tumors.
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