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:Modeling immunotherapies in live 3D human cancer tissue bioreactors.
背景:癌症免疫治疗在晚期恶性肿瘤中显示出显著疗效,但许多患者仍无应答。
**背景:**癌症免疫疗法在晚期恶性肿瘤中显示显著疗效,但许多患者仍无应答。疗效差异、不良反应及医疗成本等问题凸显需要预测性生物标志物和具有生理相关性的癌症模型,以预测个体治疗反应。现有系统无法充分重现人类肿瘤微环境(TME),而这对理解免疫—肿瘤相互作用和治疗效力至关重要。本研究开发了一种离体三维人组织培养模型,可保留原生TME,用于功能性免疫治疗测试;该短期培养平台也支持功能精准医疗,可快速评估离体治疗反应并辅助临床决策。 **方法:**将新鲜完整的人淋巴结(LN)组织块置于优化的灌流生物反应器中培养3天,期间给予CAR-T疗法和抗体类治疗。培养后采用流式细胞术、组织学和多重荧光显微镜分析。 **结果:**与传统培养板相比,生物反应器系统显著改善组织存活。具有增强PI3K信号的新型CAR-T浸润组织能力更强,但细胞毒性与常规CAR-T相当。PD-1抑制剂帕博利珠单抗显著降低淋巴瘤和黑色素瘤细胞存活率,且未影响良性淋巴结组织。 **结论:**优化后的生物反应器培养系统可在具有生理相关性的TME中稳健评估免疫疗效,有望推进个体化治疗、加速对免疫治疗机制的认识并改善临床结局。
Background: Cancer immunotherapies have shown remarkable efficacy in advanced malignancies, yet many patients remain unresponsive. This variability, along with concerns about adverse effects and healthcare costs, highlights the need for predictive biomarkers and physiologically relevant cancer models to forecast individual treatment responses. Existing systems inadequately recapitulate the human tumor microenvironment (TME), which is essential for understanding immune-tumor interactions and treatment efficacy. Here, we developed an ex vivo 3D human tissue culture model that preserves the native TME for functional immunotherapy testing. Such a short-term culture platform also supports functional precision medicine by enabling rapid ex vivo assessment of therapeutic responses to guide clinical decisions. Methods: Fresh, intact human lymph node (LN) tissue pieces were cultured in optimized perfusion bioreactors for three days, during which CAR T cell therapies and antibody-based treatments were administered. Post-culture analyses were performed using flow cytometry, histology, and multiplexed fluorescence microscopy. Results: The bioreactor system significantly improved tissue viability compared to traditional plate cultures. Novel CAR T cells with enhanced PI3K signaling exhibited superior tissue infiltration but showed comparable cytotoxicity to conventional CAR T cells. Pembrolizumab, a PD-1 inhibitor, significantly reduced lymphoma and melanoma cell viability without affecting benign LN tissues. Conclusions: This optimized bioreactor culture system provides a robust platform for evaluating immunotherapy efficacy within a physiologically relevant TME. It offers valuable potential for advancing personalized treatment strategies, accelerating the understanding of immunotherapy mechanisms, and improving clinical outcomes.
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