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:Pre-Treatment with Dacarbazine Sensitizes B16 Melanoma to CAR T Cell Therapy in Syngeneic Mouse Model.
这些发现支持对人类黑色素瘤采用 DTIC 治疗后经 CPA 预处理再输注 EGFR CAR-T 细胞的联合治疗策略具有潜在可行性。
采用嵌合抗原受体(CAR)改造T细胞进行过继细胞治疗(ACT),显著改善了血液系统恶性肿瘤结局,但用于黑色素瘤等实体瘤疗效受多种因素限制,包括肿瘤相关抗原(TAA)表达异质性,以及免疫抑制、促纤维化的肿瘤微环境(TME);后者阻碍细胞毒性CAR-T细胞向肿瘤迁移,并限制其持久性和细胞溶解活性。因此,CAR-T单药治疗黑色素瘤和其他实体瘤的应答通常较弱、短暂,甚至完全缺失。新兴证据提示,传统化疗与CAR-T联合可增强实体瘤抗肿瘤活性。化疗部分杀伤肿瘤细胞,可增加TAA可及性,并通过改变肿瘤组织整体结构破坏TME。本研究建立免疫健全的同系B16黑色素瘤小鼠模型,评估经典化疗药达卡巴嗪(DTIC)与小鼠CAR-T过继治疗联合的效果。B16-F10(简称B16)黑色素瘤细胞经改造表达可被小鼠CAR识别的人/鼠杂合表皮生长因子受体(EGFR);CAR中的单链可变片段(scFv)源自西妥昔单抗,这是一种获批用于结直肠癌及部分其他实体瘤的抗EGFR单克隆抗体。CAR-T给药前先使用环磷酰胺(CPA)预处理。结果显示,DTIC治疗后输注靶向人/鼠杂合EGFR的鼠CAR-T细胞(EGFR mCAR T),与单用DTIC或单用EGFR mCAR T相比,肿瘤控制更佳且生存延长。研究结果支持在人类黑色素瘤中探索DTIC治疗后、CPA预处理再输注EGFR CAR-T的联合治疗策略。
Adoptive cell therapy (ACT) with T cells modified with a chimeric antigen receptor (CAR T cells) has dramatically improved outcomes in hematologic cancers. However, its efficacy in solid tumors, such as melanoma, is hampered by several factors. These include heterogeneous expression of tumor-associated antigens (TAA) and an immunosuppressive, profibrotic tumor microenvironment (TME), which restricts cytotoxic CAR T cells trafficking into the tumor, as well as their persistence and cytolytic activity. As a result, responses to CAR T cell monotherapy in melanoma and other solid tumors are typically weak, transient or even absent. Emerging evidence suggests that combining traditional chemotherapy with CAR T cell therapy can enhance the antitumor activity of CAR T cells in solid malignancies. Partial tumor cell killing by chemotherapy improves access to TAA and disrupts the TME by affecting the global structure of the tumor tissue. Here, we developed an immunocompetent syngeneic B16 melanoma mouse model to test a combination of classical dacarbazine (DTIC) chemotherapy with ACT with murine CAR T cells. B16-F10 (next as B16) melanoma cells were modified to express a human/murine hybrid epidermal growth factor receptor (EGFR) recognized by a murine CAR bearing a single-chain variable fragment (scFv) derived from cetuximab, an anti-EGFR monoclonal antibody approved for the treatment of colorectal and certain other solid tumors. Prior to CAR T cells administration, cyclophosphamide (CPA) pre-conditioning was used. We demonstrated that DTIC therapy followed by infusion of murine CAR T cells targeting the human/murine hybrid EGFR (EGFR mCAR T cells) provided superior tumor control and prolonged survival compared to monotherapy with either DTIC or EGFR mCAR T cells alone. These findings support the potential feasibility of a combined therapeutic strategy for human melanoma involving DTIC treatment followed by EGFR CAR T cells infusion after CPA pre-conditioning.
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