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:Tumor irradiation promotes antigen dressing of dendritic cells to enhance CAR T cell persistence and efficacy in lung metastases.
Tumor irradiation promotes antigen dressing of dendritic cells to enhance CAR T cell persistence and efficacy in lung metastases.
转移性实体瘤仍是全球癌症死亡的主要原因。
转移性实体瘤仍是全球癌症死亡的主要原因。肿瘤负荷较高会削弱嵌合抗原受体(CAR)T细胞治疗的疗效,但脱靶毒性又限制了可安全给予的剂量。若能选择性增强CAR-T细胞在肿瘤部位的活性,或可拓宽治疗窗。在广泛转移性肺腺癌和黑色素瘤的同系小鼠模型中,我们发现,8 Gy肿瘤照射可显著增强CAR-T细胞的持续存在,而这一作用高度依赖树突状细胞(DC)。照射促进肿瘤抗原通过膜片段转移(trogocytosis)呈递到DC表面;随后,DC通过嵌合受体扩增CAR-T细胞。缺乏功能性DC时,照射无法维持CAR-T细胞的持续存在,肿瘤因而复发。照射增加了肿瘤内CAR-T细胞数量,却未增加同样表达靶抗原的邻近正常肺组织中的CAR-T细胞数量,从而在未增加毒性的情况下实现了对肿瘤的有力控制。这些数据阐明了放疗联合CAR-T细胞治疗的机制基础及其合理性。
Metastatic solid tumors remain the principal cause of cancer mortality worldwide. High tumor burden impairs responses to chimeric antigen receptor (CAR) T cell therapy, yet off-tumor toxicity limits the doses that can be safely delivered. Strategies to selectively enhance CAR T cell activity at tumor sites could widen the therapeutic window. Using syngeneic models of extensive metastatic lung adenocarcinoma and melanoma, we show that 8 Gy of tumor irradiation significantly enhanced CAR T cell persistence in a manner critically dependent on dendritic cells (DCs). Irradiation promoted trogocytic antigen dressing of tumor antigens onto DCs, which then expanded CAR T cells through the chimeric receptor. Without functional DCs, irradiation failed to sustain CAR T cell persistence and tumors relapsed. Irradiation increased CAR T cell numbers within tumors but not in adjacent normal lung tissue that also expressed target antigen, conferring robust control of tumor without increased toxicity. These data define a mechanistic basis and rationale for combining radiotherapy with CAR T cell therapy.
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