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:Phase 1 study of autologous T cells bearing fully human chimeric antigen receptors targeting mesothelin in mesothelin-expressing cancers.
所有患者(n = 20)接受 1-3 10 7 CAR + 细胞/m 2 的剂量(1 例肺腺癌、5 例间皮瘤和 14 例卵巢癌)。
这项I期研究评估了全人源抗间皮素CAR-T 细胞(huCART-meso)用于肺腺癌、卵巢癌和间皮瘤患者的安全性和可行性。huCART-meso细胞可经静脉、胸膜腔内和/或腹膜腔内给药,可联合或不联合淋巴细胞清除治疗。这些自体T细胞经工程化改造,表达具有间皮素特异性的全人源细胞外单链抗体以及4-1BB/TCR胞内信号结构域。所有患者(n=20)均接受每平方米1–3×10⁷ CAR阳性细胞(1例肺腺癌、5例间皮瘤和14例卵巢癌)。细胞峰值扩增出现在前14天内;第21天时16/20例患者可检测到huCART-meso,12个月时有5例仍可检测,其中1例超过2年仍可检测。最常见的严重不良事件为细胞因子释放综合征(7/20例,35%)。最佳总体应答为疾病稳定(12/20例,60%),靶肿瘤体积最大缩小41%。中位总生存期为26.1周,中位无进展生存期为12.3周。这些结果确立了huCART-meso治疗的可行性、安全性和初步疗效,为后续试验提供依据,理想情况下可与其他疗法联合开展。
This phase 1 study evaluated the safety and feasibility of fully human anti-mesothelin chimeric antigen receptor-T cells (huCART-meso) in patients with lung adenocarcinoma, ovarian cancer, and mesothelioma. huCART-meso cells were administered intravenously, intrapleurally, and/or intraperitoneally with or without lymphodepletion. The huCART-meso cells are autologous T cells engineered to express a fully human extracellular single-chain antibody with mesothelin specificity and 4-1BB/TCR intracellular signaling domains. All patients (n = 20) received a dose of 1-3 10 7 CAR + cells/m 2 (1 patient with lung adenocarcinoma, 5 patients with mesothelioma, and 14 patients with ovarian cancer). Peak expansion was observed within the first 14 days, and huCART-meso cells were detectable in 16/20 patients at day 21 and in 5 patients at 12 months, with 1 patient showing detectable cells for over 2 years. The most common serious adverse event was cytokine release syndrome (7/20 patients, 35%). The best overall response was stable disease (12/20 patients, 60%), with a maximum reduction in target tumor volume of 41%. The median overall survival was 26.1 weeks, and the median progression-free survival was 12.3 weeks. These results establish the feasibility, safety, and preliminary efficacy of huCART-meso therapy, providing a rationale for future trials, ideally in combination with other therapies.
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