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:Low-Strength Type I Interferon Signaling Promotes CAR T-cell Treatment Efficacy.
这些结果共同确立 IFN-I 是一种强效且不依赖共刺激的 CAR-T 细胞疗效增强因子,并提供了一种可转化落地的增强 CAR-T 细胞疗法的方法。
靶向 CD19 的嵌合抗原受体(CAR)T 细胞疗法显著推动了复发/难治性弥漫性大 B 细胞淋巴瘤(r/r DLBCL)的治疗进展,但仍有多达 60% 的患者无法达到完全缓解。为明确疗效决定因素,研究者对 8 名接受 axicabtagene ciloleucel、且临床应答各异的 r/r DLBCL 患者输注产品(IP)开展单细胞转录组分析。与疾病进展患者相比,完全应答患者的 IP 富集 I 型干扰素(IFN-I)信号特征。基于这一发现,研究者开发了一种提高 CD19 靶向 CAR-T 疗效的策略:在体外制备过程中加入 IFN-I 作为增强因子,并在 CAR-T 输注前去除 IFN-I,以避免体内毒性。对于 CD28 或 4-1BB 共刺激的第二代 CAR,低强度 IFN-I 信号均增强了 CAR-T 对 B 细胞淋巴瘤和白血病的细胞毒性及治疗效果。低强度 IFN-I 增强型 CAR-T 体外制备策略采用现有 FDA 批准药物,可避免体内干扰素相关毒性,并完全兼容当前 CAR 构建体和制备流程。总之,本研究确立 IFN-I 是一种强效且不依赖共刺激方式的 CAR-T 疗效增强因子,并提供了具有转化可行性的 CAR-T 增效策略。
CD19-directed chimeric antigen receptor (CAR) T-cell therapy has significantly advanced the treatment landscape for relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL). However, up to 60% of patients do not achieve a complete response. To uncover determinants of therapeutic efficacy, we analyzed the infusion products (IPs) of eight r/r DLBCL patients with distinct clinical responses to axicabtagene ciloleucel using single-cell transcriptomics. Compared with patients who exhibited progressive disease, IPs of complete responders demonstrated enriched signatures of type I interferon (IFN-I) signaling. Based on these findings, we developed a strategy to improve CD19-directed CAR T-cell treatment efficacy by incorporating IFN-I as an enhancer during the ex vivo manufacturing process, with IFN-I removal before CAR T-cell infusion to avoid in vivo toxicities. For both CD28- and 4-1BB-costimulated second-generation CARs, we found that low-strength IFN-I signaling enhanced CAR T-cell cytotoxicity and treatment efficacy against B-cell lymphoma and leukemia. Our low-strength IFN-I-enhanced CAR T-cell ex vivo manufacturing approach leverages an existing FDA-approved pharmacologic agent, circumvents in vivo interferon-associated toxicities, and remains fully compatible with current CAR constructs and manufacturing workflows. Together, our results establish IFN-I as a potent and costimulation-independent enhancer of CAR T-cell efficacy and provide a translationally feasible approach to enhance CAR T-cell therapies.
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