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:T cells dressed up with a dual HLA-restricted TCR targeting cathepsin G drive effective AML eradication.
尽管AML具有免疫敏感性,但遗传异质性、低突变负荷以及缺乏肿瘤特异性抗原阻碍了免疫治疗在急性髓系白血病(AML)中取得成功。
尽管AML具有免疫敏感性,但遗传异质性、低突变负荷以及缺乏肿瘤特异性抗原阻碍了免疫治疗在急性髓系白血病(AML)中的成功。T细胞受体(TCR)通过靶向AML各亚型共有的肿瘤相关胞外和胞内抗原,提供了一条有前景的途径;然而,HLA限制性限制了其潜力。我们发现了一种强效TCR,能够识别组织蛋白酶G(CTSG)的肽段——CTSG是一种局限于中性粒细胞颗粒中的丝氨酸蛋白酶,但在原始细胞的细胞质中异常定位——当其由HLA-A 24:02和HLA-C 07:02(高度常见的等位基因)呈递时。利用TCR基因编辑和CD8共受体转导,我们工程化构建了一个强健的T细胞群体,包含功能增强的CD4+CD8+ T淋巴细胞,且未改变亚群身份。表达CTSG-TCR的T细胞在体外和体内对原代原始细胞表现出强效且特异性的细胞毒性。值得注意的是,未观察到外周血细胞群体、骨髓造血或髓外造血器官(脾和肝)的改变,证明了最佳的靶向肿瘤、脱靶正常组织的安全性特征。此外,通过肽段诱变证明了不存在脱靶交叉反应性,突显了该TCR对CTSG的特异性。这些结果揭示了双重限制性TCR的潜力,以及CTSG-TCR T细胞作为广泛AML患者群体的强效治疗手段的潜力。
Despite immunosensitivity, genetic heterogeneity, low mutational burden, and lack of tumor-specific antigens hinder immunotherapy success for acute myeloid leukemia (AML). T-cell receptors (TCRs) offer a promising route by targeting tumor-relevant extracellular and intracellular antigens shared across AML subtypes; however, HLA restriction limits their potential. We identified a potent TCR capable of recognizing peptides of cathepsin G (CTSG), a serine protease confined to neutrophil granules but aberrantly localized in the cytoplasm of blasts, when presented by HLA-A 24:02 and HLA-C 07:02, highly frequent alleles. Leveraging TCR gene-editing and CD8 coreceptor transduction, we engineered a robust T-cell population, comprising CD4+CD8+ T lymphocytes with enhanced functionality, without altering subset identity. T cells expressing the CTSG-TCR exhibited strong and specific cytotoxicity against primary blasts, in vitro and in vivo. Noticeably, no alterations in peripheral blood cell populations, bone marrow hematopoiesis, or extramedullary hematopoietic organs (the spleen and liver) were observed, demonstrating optimal on-target, off-tumor safety profile. Moreover, the absence of off-target cross-reactivity was proved by peptide mutagenesis, highlighting the specificity of the TCR for CTSG. These results reveal the potential of dual restricted TCRs, and of CTSG-TCR T cells as powerful therapeutics for a broad population of patients with AML.
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