抗 CD22/CD19 CAR-T 细胞疗法 CART2219.1 在成人和儿童复发/难治性 B-ALL 中的 I/II 期试验
A Phase I/II Trial of Anti-CD22/CD19 CAR-T Cell Therapy, CART2219.1, in Adult and Pediatric Relapsed/Refractory B-ALL.
在一项多中心I/II期试验中,所有患者(n=11;7名儿童,4名成人)在第28天均达到完全缓解(91%为微小残留病阴性)。
英文原题:Enhancing CAR- and TCR-mediated targeting of cancer via an immune synapse-stabilizing receptor.
癌细胞上抗原表达的异质性限制了工程化T细胞疗法的临床获益,并通过抗原逃逸导致治疗耐药。
癌细胞上抗原表达的异质性限制了工程化T细胞疗法的临床获益,并通过抗原逃逸导致治疗耐药。在此,我们提出一种策略,通过一个独立的工程化受体选择性增强细胞毒性信号传导和免疫突触形成,从而改善对抗原表达欠佳肿瘤的识别和裂解。这种突触稳定受体(SSR)含有修饰的T细胞活化连接蛋白(LAT)胞内结构域,在结合次要肿瘤抗原后放大CD3ζ信号传导,导致Ca2+通量增强、MAPK和NF-kB信号激活、免疫突触成熟以及T细胞脱颗粒增强。去除LAT胞内结构域中C端氨基酸178-233(LAT177)对于最小化SSR介导的细胞毒性是必要的。在急性髓系白血病模型中,我们展示了一种靶向CD38的SSR通过C型凝集素样分子-1(CLL1)特异性嵌合抗原受体(CAR)和survivin特异性T细胞受体(TCR)增强对抗原低表达癌细胞的细胞裂解。与另一种CAR不同,SSR对正常CD38+组织不产生显著细胞毒性。因此,我们的研究表明,SSR武装增强了对抗原异质性癌症的靶向作用,同时不损害治疗性T细胞的安全性和选择性。
Heterogeneity in antigen expression on cancer cells limits clinical benefit of engineered T-cell therapies and underpins treatment resistance through antigen escape. Here, we present a strategy to improve recognition and lysis of tumors with suboptimal antigen expression through a separate engineered receptor that selectively boosts cytotoxic signaling and immune synapse formation. This synapse-stabilizing receptor (SSR) harbors a modified linker for activation of T cells (LAT) endodomain that amplifies CD3ζ signaling upon binding to a secondary tumor antigen resulting in an augmented Ca2+ flux, activation of MAPK and NF-kB signaling, maturation of immune synapse, and enhanced T-cell degranulation. Removing C-terminal amino acids 178-233 in the LAT endodomain (LAT177) was necessary to minimize SSR-mediated cytotoxicity. In models of acute myeloid leukemia, we show that a CD38-targeting SSR boosts cytolysis of antigen-low cancer cells via a C-type lectin-like molecule-1 (CLL1)-specific chimeric antigen receptor (CAR) and a survivin-specific T cell receptor (TCR). Unlike another CAR, SSR does not produce significant cytotoxicity against normal CD38+ tissues. Our study thus shows that SSR arming enhances targeting of antigenically heterogeneous cancers without compromising safety and selectivity of therapeutic T cells.
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