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:Multi-omic profiling and preclinical efficacy of fratricide-driven, unedited CD7 CAR-T cells in T-cell leukemia.
这些数据支持调整标准生产方案以克服自相残杀的可行性,并证明可规模化、未经编辑的 UMCG-001 细胞用于治疗 T 细胞恶性肿瘤的临床转化潜力。
背景:嵌合抗原受体(CAR)T细胞疗法在治疗CD7阳性T细胞恶性肿瘤方面前景广阔。然而,限制CD7靶向CAR临床开发的一项主要挑战是同类相残,即恶性细胞和健康细胞共同表达CD7导致的自我细胞毒作用。目前的解决方案包括CD7基因编辑、细胞内滞留或细胞分选策略,但这些方法显著增加复杂性和成本,限制了疗法的可行性和成本效益。本研究评估,能否通过调整常规制备方案克服同类相残并生成有效CAR-T细胞产品。具体而言,我们报告符合GMP规范的UMCG-001开发过程。这是一种非专有、由学术机构开发的第三代配体型CD7靶向自体CAR-T产品。 方法:研究者采用不同细胞因子组合和GMP级人血小板裂解物(HPL),按照标准制备流程探索UMCG-001的生产。利用健康供者和患者材料优化符合GMP规范的工艺,随后转移至GMP设施。通过体外和体内实验评估UMCG-001的抗白血病活性,并进行深入多组学表征,以评估同类相残阶段对产品质量的影响。 结果:在离体扩增阶段补充人血小板裂解物,可有效恢复发生同类相残的CAR CD7低表达/阴性细胞的扩增能力并提高其存活率。这些未进行基因编辑的细胞表现出强效CD7特异性抗白血病活性,在T-ALL异种移植模型中使长期生存率达到约90%。值得注意的是,光谱流式和单细胞RNA测序显示,细胞富集了中央记忆表型,TCR多样性高,活化/增殖特征增强。UMCG-001的耗竭特征与作为基准的CD19 CAR-T相当。这些结果证实,同类相残筛选过程保留了多样且功能良好的T细胞库。最后,研究成功利用自体患者材料制备UMCG-001批次,未检测到恶性原始细胞污染。 结论:这些数据支持通过调整标准制备流程克服同类相残的可行性,并显示可规模化生产、未经基因编辑的UMCG-001细胞有望转化至临床,用于治疗T细胞恶性肿瘤。
BACKGROUND: Chimeric Antigen Receptor (CAR)-T cell therapy holds considerable promise for the treatment of CD7+ T cell malignancies. However, a major challenge limiting clinical development of CD7-targeted CARs has been fratricide, a process of self-cytotoxicity caused by the shared expression of CD7 on malignant and healthy cells. Current solutions, including CD7 gene editing, intracellular retention or cell-sorting strategies, add significant complexity and cost, thereby limiting the feasibility and cost-effectiveness of this therapy. In this study, we evaluated whether fratricide can instead be overcome by tailoring standard manufacturing protocols to generate effective CAR-T cell products. Specifically, we report the GMP-compliant development of UMCG-001, a non-proprietary, academically generated, third-generation ligand-based CD7-targeting autologous CAR-T product. METHODS: Production of UMCG-001 was explored using standard manufacturing protocols with various cytokine mixtures and GMP-grade human plate lysate (HPL). A GMP-compliant process was optimized with both healthy donor and patient material and subsequently transferred to our GMP facility. The anti-leukemic activity of UMCG-001 was assessed in vitro and in vivo, followed by in-depth multi-omics characterization to evaluate the impact of the fratricide phase on product quality. RESULTS: Supplementation with human platelet lysate during the ex vivo expansion phase effectively restored expansion and improved viability of fratricide-driven CAR CD7Low/Neg cells. These unedited cells exhibited robust CD7-specific antileukemic activity and achieved ~ 90% prolonged survival in a T-ALL xenograft model. Notably, spectral flow and single-cell RNA sequencing revealed enrichment of a central memory phenotype and a high TCR diversity, with increased activation/proliferation profile. Importantly, the exhaustion profile of UMCG-001 remained comparable to benchmark CD19 CAR-T. These results confirmed that the fratricide selection process maintained a diverse and functionally competent T cell repertoire. Finally, UMCG-001 batches were successfully manufactured from autologous patient-derived material with no detectable contamination through malignant blasts. CONCLUSIONS: These data support the feasibility of adapting standard manufacturing protocols to overcome fratricide and demonstrate the potential for clinical translation of scalable, unedited UMCG-001 cells for the treatment of T-cell malignancies.
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