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:The Landscape of Clinical Trials for Claudin18.2-Positive Gastric Cancer.
CLDN18.2 已成为胃癌靶向治疗的重要新靶点。
目的:胃癌仍是全球重要的健康挑战,晚期疾病预后尤为严峻。Claudin蛋白家族成员Claudin-18.2(CLDN18.2)在维持胃黏膜紧密连接方面发挥关键作用,并已成为有前景的治疗靶点。本研究旨在总结靶向CLDN18.2药物治疗胃癌的临床试验现状,为相关研发提供参考,并系统分析全球胃癌CLDN18.2临床试验格局。 方法:利用Citeline Pharma Intelligence(TrialTrove数据库)检索靶向CLDN18.2阳性胃癌的临床试验,并从试验数量、阶段、状态、地域分布和主要受试药物等多个维度进行分析。 结果:经严格筛选,最终纳入143项临床试验。CLDN18.2阳性胃癌研究快速推进,自2021年以来试验数量明显增加。多数试验(69.93%)仍处于早期探索阶段(I期或I/II期);随着初步数据呈现前景,II期和III期试验数量有所增加。目前已启动2项IV期试验,均研究佐妥昔单抗。试验主要集中于东亚、北美和欧洲;中国在独立研究和合作研究中均居领先地位,其次为美国,后者拥有最广泛的国际合作网络。主要受试药物中,单克隆抗体占32.17%,抗体药物偶联物占26.57%,CAR-T疗法占23.08%。双特异性抗体、BiTE、AOC和CAR-NK等其他药物也体现出该领域持续创新。 结论:CLDN18.2已成为胃癌靶向治疗的重要新靶点。相关临床试验和药物研发进展迅速,药物类型多样。未来更多数据公布后,治疗策略有望进一步优化,并为胃癌患者提供新的治疗选择。
OBJECTIVES: Gastric cancer continues to pose a notable global health challenge, with advanced-stage disease carrying a guarded prognosis. Claudin-18.2 (CLDN18.2), as a member of the Claudin protein family, plays a crucial role in maintaining gastric mucosal tight junctions and has emerged as a promising therapeutic target. To summarize the current clinical trial status of CLDN18.2-targeted drugs for gastric cancer and support related research and development efforts, this study systematically analyzed the global landscape of clinical trials focusing on CLDN18.2 in gastric cancer. METHODS: We searched for clinical trials targeting CLDN18.2-positive gastric cancer using the Citeline Pharma Intelligence (TrialTrove database) and analyzed them across multiple dimensions, including trial number, phase, status, geographical distribution, and primary tested drug. RESULTS: Through strict screening procedures, 143 clinical trials were finally included in this study. Research into CLDN18.2-positive gastric cancer is advancing fast, with a marked increase in trials since 2021. Most trials (69.93%) remain in early-phase exploration (phase I/I-II). Phase II and III trials, however, have increased as initial data show promise. Currently, 2 phase IV trials, both investigating zolbetuximab, have been initiated. Geographically, trial activity is concentrated in East Asia, North America, and Europe, with China leading in both independent and collaborative efforts, followed by the United States, which maintains the broadest international partnership network. For types of primary tested drugs, monoclonal antibodies (32.17%), antibody-drug conjugates (26.57%), and CAR-T therapies (23.08%) are the most common. Other drugs like bispecific antibodies, BiTEs, AOCs, and CAR-NK cells also point to continuous innovation in this field. CONCLUSIONS: CLDN18.2 has become a major new target in gastric cancer targeted therapy. Its clinical trials and development are advancing quickly, with various types of drugs available. In the future, more released data may make treatment strategies better and give new treatment options to gastric cancer patients.
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