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:Treatment of acute myeloid leukemia using CD3/CD123 bispecific antibody-engaged γδT cells in a mouse xenograft model.
CD3/CD123 BsAbs有效重定向γδ T细胞,使其选择性靶向并清除AML细胞,为AML的治疗提供了一种有前景的免疫治疗策略。
急性髓系白血病(AML)是一种侵袭性血液系统恶性肿瘤,临床结局不佳。CD123是IL-3受体的α链,在AML原始细胞上异常过表达,是靶向免疫治疗的一个有前景的靶点。然而,CD123靶向免疫治疗的临床应用受到治疗相关毒性的严重制约,这些毒性会破坏正常造血稳态。相比之下,γδ T细胞具有以主要组织相容性复合体(MHC)非依赖方式识别抗原的独特能力,对正常组织发挥的细胞毒性极小。在与CD3/CD123双特异性抗体(BsAbs)特异性激活和结合后,这些细胞能够强效且选择性地靶向CD123⁺ AML原始细胞,同时降低CRS风险,为AML提供了一种更安全、更有效的治疗策略。
本研究旨在探讨一种新型免疫治疗策略,即利用CD3/CD123双特异性抗体(BsAbs)衔接体外扩增的γδT细胞,从而增强其靶向CD123⁺ AML原始细胞的能力,并在体外和体内提高治疗效果。
从外周血中分离单个核细胞(PBMCs),随后在体外扩增其γδ T细胞。将扩增后的γδ T细胞与CD3/CD123 BsAbs共孵育以实现靶向结合。通过细胞毒性实验和细胞因子分泌谱分析,在体外评估CD3/CD123 BsAbs偶联γδ T细胞的抗AML活性。在体内评估中,通过接种Molm-13-Luc细胞在NCG小鼠中建立AML异种移植模型,并进一步在该模型中评估CD3/CD123 BsAbs武装(预孵育并洗涤)的γδ T细胞的治疗效果。
CD3/CD123 BsAbs 武装的 γδ T 细胞对已建立的 CD123⁺ AML 细胞系(Molm-13、THP-1)和原代患者来源的 AML 细胞均表现出强效且 CD123 依赖性的细胞毒性。这种细胞毒性效应伴随着效应细胞因子 IFN-γ 和 TNF-α 的大量产生,表明 γδ T 细胞介导的免疫反应被激活。在携带 Molm-13-Luc AML 细胞的 NCG 小鼠异种移植模型中,与接受未修饰 γδ T 细胞或单独 BsAbs 的对照组相比,BsAbs 武装的 γδ T 细胞治疗导致白血病浸润显著减少,并显著延长了动物生存期。
BACKGROUND: Acute myeloid leukemia (AML) is an aggressive hematologic malignancy characterized by dismal clinical outcomes. CD123, theαchain of the IL-3 receptor, is aberrantly overexpressed on AML blasts, representing a promising target for targeted immunotherapy. However, the clinical utility of CD123-targeted immunotherapies has been severely hampered by treatment-associated toxicities that disrupt normal hematopoietic homeostasis. In contrast, γδ T cells, endowed with the unique capacity to recognize antigens in a major histocompatibility complex (MHC)-independent manner, exert minimal cytotoxicity against normal tissues. Upon specific activation and engagement with CD3/CD123 bispecific antibodies (BsAbs), these cells potently and selectively target CD123⁺ AML blasts while mitigating CRS risk, offering a safer and more effective AML therapeutic strategy. OBJECTIVE: This study aims to investigate a novel immunotherapeutic strategy that employs CD3/CD123 bispecific antibodies (BsAbs) to engage ex vivo expanded γδT cells, thereby enhancing their targeting of CD123⁺ AML blasts and therapeutic efficacy both in vitro and in vivo. METHODS: The mononuclear cells were isolated from peripheral blood (PBMCs) and their γδ T cells were subsequently expanded in vitro. The expanded γδ T cells were co-incubated with CD3/CD123 BsAbs to achieve targeted engagement. The anti-AML activity of CD3/CD123 BsAbs-conjugated γδ T cells was evaluated in vitro via cytotoxicity assays and cytokine secretion profiling. For the in vivo assessment, an AML xenograft model was established in NCG mice by inoculation with Molm-13-Luc cells, and the therapeutic efficacy of the CD3/CD123 BsAbs-armed (pre-incubated and washed) γδ T cells was further evaluated in this model. RESULTS: CD3/CD123 BsAbs- armed γδ T cells exhibited potent and CD123-dependent cytotoxicity against both established CD123⁺ AML cell lines (Molm-13, THP-1) and primary patient-derived AML cells. This cytotoxic effect was accompanied by robust production of the effector cytokines IFN-γand TNF-α, indicating activation of the γδ T cell-mediated immune response. In the NCG mouse xenograft model bearing Molm-13-Luc AML cells, treatment with BsAbs- armed γδ T cells resulted in a significant decrease in leukemic infiltration and a pronounced extension of animal survival when compared with control groups receiving unmodified γδ T cells or BsAbs alone. CONCLUSION: The CD3/CD123 BsAbs effectively redirects γδ T cells to selectively target and eliminate AML cells, providing a promising immunotherapeutic strategy for the treatment of AML.
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