CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Anti-B-cell Maturation Antigen Chimeric Antigen Receptor T-cell Therapy bb21217 for Relapsed and Refractory Multiple Myeloma: Results from the Phase I CRB-402 Study.
Anti-B-cell Maturation Antigen Chimeric Antigen Receptor T-cell Therapy bb21217 for Relapsed and Refractory Multiple Myeloma: Results from the Phase I CRB-402 Study.
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富集记忆样表型的嵌合抗原受体(CAR)T细胞,可能比未富集产品持久更久、功能更强,从而延长应答持续时间(DOR)。我们在复发/难治性多发性骨髓瘤患者(N=72)中开展I期研究,评估抗B细胞成熟抗原CAR-T 疗法bb21217(NCT03274219)。该疗法在制备过程中加入磷脂酰肌醇3-激酶抑制剂bb007,以富集记忆样T细胞。bb21217治疗未出现新的安全性问题(观察到3例3级细胞因子释放综合征和3例3级神经毒性)。客观缓解率为69.4%,中位DOR为23.8个月(95%置信区间16.8–34.8)。药品制剂分析显示,早期记忆表型与强劲扩增和深度应答相关。基线特征分析提示,肿瘤负荷和既往治疗会影响DOR。数据表明,在疾病病程较早、肿瘤负荷较低且起始材料呈现较幼稚表型时制备CAR-T 细胞,可能最大程度发挥药品制剂的临床获益潜力。
Chimeric antigen receptor (CAR) T-cell therapy enriched for a memory-like phenotype may persist and function longer than a nonenriched product, thereby improving duration of response (DOR).
We conducted a phase I study with bb21217 (NCT03274219), an anti-B-cell maturation antigen CAR T-cell therapy manufactured in the presence of the phosphoinositide 3-kinase inhibitor bb007 to enrich for T cells with a memory-like phenotype, in patients with relapsed/refractory multiple myeloma (N = 72). No new safety concerns were raised with bb21217 therapy (three cases each of grade 3 cytokine release syndrome and grade 3 neurotoxicity were observed). The objective response rate was 69. 4% and the median DOR was 23.
8 (95% confidence interval, 16. 8-34. 8) months. Analysis of the drug product established an association between early memory phenotype and robust expansion and depth of response. Examination of baseline characteristics indicated that tumor burden and prior therapies influenced DOR. The data indicate that generation of CAR T cells early in a disease course when tumor burden is lower and source material exhibits a more na ve phenotype may maximize the clinical benefit potential of the drug product.
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