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:Trispecific targeting of T cells engineered with TCR mimic antibodies to limit antigen escape.
靶向WT1肽/HLA-A2复合物的免疫蛋白酶体依赖性和非依赖性表位的三特异性T细胞,加上识别第三种肿瘤相关抗原的CSR,提供了一种有效且经济高效的方法来克服肿瘤免疫逃逸。
抗原缺失和肿瘤异质性对成功的免疫治疗构成了重大挑战。基于T细胞受体(TCR)的疗法依赖于识别由主要组织相容性复合体I类分子在细胞表面呈递的细胞内肿瘤蛋白来源的表位。实体瘤细胞通常缺乏免疫蛋白酶体,而免疫蛋白酶体对于加工和呈递某些免疫原性表位至关重要。一种有效的策略是同时靶向多种肿瘤抗原,从而在疾病复发时提供关键的挽救,以降低抗原缺失和肿瘤异质性的风险。此前,我们将一种特异性针对HLA-A2背景下Wilm's瘤1(WT1)来源表位RMFPNAPYL(RMF)的TCR模拟单克隆抗体(TCRm)"ESK2"改造为一种新的CAR-T 细胞形式,即抗体-TCR受体(AbTCR)-嵌合信号受体(CSR)。然而,RMF表位在很大程度上依赖于免疫蛋白酶体的加工,而免疫蛋白酶体可能从白血病细胞中丢失,有时在实体瘤细胞中也不存在。
为了减轻抗原丢失、肿瘤异质性并拓宽AbTCR T细胞的适用范围,我们将ESK2与一种新的TCRm结合,该TCRm针对来源于WT1的、不依赖免疫蛋白酶体的表位VLDFAPPGA(VLD),在HLA-A2分子的背景下,命名为ESK3。ESK2和ESK3被串联工程化到一个AbTCR-CSR构建体中,同时识别WT1 RMF和VLD两个表位。为了增加额外的特异性和效力,这些细胞中的CSR被工程化改造,使其带有针对CD33(用于治疗白血病)或间皮素(用于治疗实体瘤)的单链可变片段(scFv)。AbTCR-CSR的特异性和疗效在体外和体内均进行了评估。
体外研究证明,Tri-AbTCR-CSR(CD33 CSR)T细胞对大多数急性髓系白血病细胞表现出最佳的杀伤活性。与Tri-AbTCR或ESK2和ESK3 AbTCR-CSR联合相比,ESK3 AbTCR-CSR(mesothelin CSR)对大多数实体瘤细胞系表现出相似水平的细胞毒性。在动物治疗模型中,三特异性AbTCR-CSR T细胞对造血系统或实体瘤细胞显示出与单ESK2-AbTCR或ESK3-AbTCR-CSR T细胞相当的疗效,进一步支持了三重靶向策略的优势,克服了表位丢失变异体。
BACKGROUND: Antigen loss and tumor heterogeneity present significant challenges for successful immunotherapies. T-cell receptor (TCR)-based therapies rely on the recognition of epitopes derived from intracellular tumor proteins presented by major histocompatibility complex class I molecules on cell surface. Solid tumor cells frequently lack immunoproteasomes, which are crucial for processing and presenting certain immunogenic epitopes. An effective strategy to mitigate the risk of antigen absence and tumor heterogeneity is to simultaneously target multiple tumor antigens, thereby providing critical rescue from disease relapse. Previously, we engineered a TCR mimic monoclonal antibody (TCRm) "ESK2", specific for Wilm's tumor 1 (WT1)-derived epitope RMFPNAPYL (RMF) in the context of HLA-A2, into a new chimeric antigen receptor T-cell format, antibody-TCR receptor (AbTCR)-chimeric signaling receptor (CSR). However, the RMF epitope is largely dependent on processing by the immunoproteasomes, which can be lost from leukemia cells and sometimes absent in solid tumor cells. METHODS: To mitigate antigen loss, tumor heterogeneity and broaden the reach of AbTCR T cells, we combined ESK2 with a new TCRm for an immunoproteosome-independent epitope derived from WT1, VLDFAPPGA (VLD), in the context of HLA-A2 molecules, named ESK3. ESK2 and ESK3 were tandemly engineered into one AbTCR-CSR construct, simultaneously recognizing both the WT1 RMF and VLD epitopes. To add additional specificity and potency, a CSR in these cells was engineered with a single chain variable fragment (scFv) for either CD33 to treat leukemia or mesothelin to treat solid tumors. The specificity and efficacy of the AbTCR-CSRs were evaluated in both in vitro and in vivo. RESULTS: In vitro studies demonstrated that the Tri-AbTCR-CSR (CD33 CSR) T cells showed the best killing activity against most acute myeloid leukemia cells. Similar levels of cytotoxicity were exhibited by ESK3 AbTCR-CSR (mesothelin CSR) against most solid tumor cell lines when compared with the Tri-AbTCR or a combination of ESK2 and ESK3 AbTCR-CSR. In animal therapy models, trispecific AbTCR-CSR T cells showed efficacy equivalent to single ESK2-AbTCR or ESK3-AbTCR-CSR T cells, against hematopoietic or solid tumor cells, further supporting the advantage of triple targeting strategy, overcoming epitope loss variants. CONCLUSIONS: Trispecific T cells targeting immunoproteasome-dependent and independent epitopes of WT1 peptide/HLA-A2 complexes, plus a CSR recognizing a third tumor-associated antigen, present an effective and cost-efficient approach for overcoming tumor immune evasion.
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