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:Integrated Chronic In Vivo and In Vitro Screens Uncover NFIL3 as a Driver of T-cell Dysfunction.
未标注:嵌合抗原受体(CAR)疗法已改变血液系统恶性肿瘤的治疗格局,但其在实体瘤中的疗效有限,部分原因在于工程化T细胞的功能持久性不足。
嵌合抗原受体(CAR)疗法已经改变了血液系统恶性肿瘤的治疗格局,但其在实体瘤中的疗效有限,部分原因在于工程化T细胞的功能持久性不足。为了阐明其功能衰退的基础,我们对400个转录因子进行了体内和体外整合的慢性筛选,发现NFIL3是CAR T细胞功能障碍的驱动因素。在CAR T细胞中基因敲除NFIL3可维持其扩增并增加细胞因子产生,总体上抑制终末分化。NFIL3缺失增强了CAR T细胞疗效,在不同CAR设计的异种移植和同基因小鼠肿瘤模型中改善了肿瘤控制并延长了生存期。在慢性刺激下,敲除NFIL3建立了一种可预测有利临床结局的转录状态。我们的发现强调了整合全面体内遗传筛选与多参数体外评估的强大威力,并将NFIL3确定为增强癌症免疫治疗的新治疗靶点。意义:本研究提出了一个两步筛选框架,将体内 pooled guide RNA 筛选与多参数体外阵列筛选相结合。NFIL3成为首要候选因子,其敲除增强了CAR T细胞在血液系统恶性肿瘤和实体瘤中跨多种CAR结构的抗肿瘤疗效。
UNLABELLED: Chimeric antigen receptor (CAR) therapy has transformed the treatment landscape for hematologic malignancies, but its efficacy in solid tumors is limited, owing in part to insufficient functional persistence of the engineered T cells. To elucidate the basis for their functional decline, we conducted integrated chronic in vivo and in vitro screens of 400 transcription factors, which revealed NFIL3 as a driver of CAR T-cell dysfunction. Genetic disruption of NFIL3 in CAR T cells sustains their expansion and increases cytokine production, overall restraining terminal differentiation. Loss of NFIL3 enhances CAR T-cell efficacy, improving tumor control and prolonging survival in xenograft and syngeneic mouse tumor models across different CAR designs. Under chronic stimulation, disruption of NFIL3 establishes a transcriptional state predictive of favorable clinical outcomes. Our findings underscore the power of comprehensive in vivo genetic screens integrated with multiparameter in vitro assessment and identify NFIL3 as a novel therapeutic target to enhance cancer immunotherapy. SIGNIFICANCE: This study presents a two-step screening framework, integrating an in vivo pooled guide RNA screen with a multiparameter, in vitro arrayed screen. NFIL3 emerged as the top candidate, and its disruption enhanced CAR T-cell antitumor efficacy in both hematologic malignancies and solid tumors across diverse CAR architectures.
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