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:Perspectives on PCR-Based Cellular Kinetics and Biodistribution Analysis for Emerging Adoptive Cell Therapies.
越来越多的嵌合抗原受体(CAR)T 细胞疗法已被开发并在临床研究中接受评估,其中已有数款获 FDA 批准的疗法靶向血液系统恶性肿瘤上的 CD19 和 BCMA 抗原。
近年来,越来越多嵌合抗原受体(CAR)T细胞疗法被开发并进入临床研究,数种靶向血液系统恶性肿瘤CD19或BCMA抗原的疗法已获FDA批准。为将适应证拓展至实体瘤和自身免疫病,新一代CAR-T疗法正在探索新的肿瘤相关抗原、异体方案及细胞因子增强设计等,以克服安全性顾虑、复发率、肿瘤微环境障碍、患者可及性及生产复杂性等现有局限。细胞动力学和生物分布评估对于理解细胞疗法的疗效和安全性至关重要,因为这类“活药物”在体内通常经历分布、扩增、收缩和持续存在四个阶段。数字微滴PCR已成为细胞与基因疗法转基因定量的首选技术,具有更高灵敏度、特异性、重复性和绝对定量能力;作为终点PCR,其耐受PCR抑制的能力也更强。与此同时,CAR-T细胞动力学和生物分布研究仍面临若干独特挑战,取决于项目阶段、免疫细胞类型及目标适应证(血液肿瘤、实体瘤或自身免疫病)。本文观点综述讨论利用PCR评估新兴过继细胞疗法项目的细胞动力学和生物分布时需要考虑的问题与挑战。
A growing number of chimeric antigen receptor (CAR) T-cell therapies have been developed and investigated in clinical studies, with several FDA-approved therapies targeting CD19 and BCMA antigens on hematological malignancies. To further expand the indication to solid tumors and autoimmune diseases, a new generation of CAR T-cell therapies has been investigated to explore new tumor-associated antigens, allogeneic options, and cytokine armoring strategies, etc. to overcome the current limitations, including safety concerns, relapse rates, tumor microenvironment challenges, patient accessibility and manufacturing complexities. Cellular kinetics and biodistribution assessments are crucial in understanding the efficacy and safety of cell therapy, as a living drug that typically exhibits four distinct phases: distribution, expansion, contraction, and persistence within the body. Droplet digital PCR has emerged as the technology of choice in cell and gene therapy for transgene quantification with higher sensitivity, specificity, reproducibility, and absolute quantification, and as an end-point PCR provides higher tolerance to PCR inhibition. In the meantime, several unique challenges remain to be addressed in the cellular kinetics and biodistribution studies of CAR T, depending on the program stage, types of immune cells, and target indication (hematological and solid tumors, autoimmune). This opinion paper discusses the challenges and considerations of PCR-based cellular kinetics and biodistribution assessment to support emerging adoptive cell therapy programs.
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