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非基因编辑、靶向 CD19 的同种异体 CAR-T 细胞疗法治疗复发或难治性 B 细胞急性淋巴细胞白血病:一项开放标签、单臂 1 期研究

英文原题:Non-gene-edited, CD19-targeted, allogeneic CAR-T cell therapy for relapsed or refractory B-cell acute lymphoblastic leukemia: an open-label, single-arm phase 1 study.

PubMed 2026/06/04(内容时间) Bone Marrow Transplant Q1 · IF 5.1(JCR 2025)

研究概要

在中位随访31个月时,1年无进展生存率和总生存率分别为30%和40%。

中文摘要

自体嵌合抗原受体(CAR)-T细胞疗法对复发或难治性B细胞急性淋巴细胞白血病(R/R B-ALL)有效,但其临床应用受到生产失败、高成本和可及性有限的限制。基因编辑的同种异体CAR-T细胞提供了一种现货型替代方案,但关于基因组不稳定性和移植物抗宿主病(GVHD)的担忧仍然存在。我们开展了一项1期研究,评估ThisCAR-T——一种非基因编辑的、靶向CD19的同种异体CAR-T细胞产品——在R/R B-ALL患者中的安全性和疗效。11例患者接受了递增剂量ThisCAR-T治疗,分别为1 10 6、3 10 6和5 10 6个细胞/kg。1例患者在输注后退出。在其余10例患者中,8例发生细胞因子释放综合征,其中7例为1-2级,1例为3级。2例患者发生免疫效应细胞相关神经毒性综合征(分别为1级和4级)。未观察到GVHD。在第28天,9例可评估患者中有8例达到完全缓解(CR)或伴血液学恢复不完全的CR(CRi)。在中位随访31个月时,1年无进展生存率和总生存率分别为30%和40%。ThisCAR-T表现出良好的安全性和有前景的抗白血病活性,支持其作为R/R B-ALL新型疗法的潜力。

展开英文摘要原文

Autologous chimeric antigen receptor (CAR)-T cell therapy is effective in relapsed or refractory B-cell acute lymphoblastic leukemia (R/R B-ALL), but its clinical application is restricted by manufacturing failures, high costs, and limited accessibility. Gene-edited allogeneic CAR-T cells offer an off-the-shelf alternative, yet concerns remain regarding genomic instability and graft-versus-host disease (GVHD). We conducted a phase 1 study to assess the safety and efficacy of ThisCAR-T, a non-gene-edited, CD19-directed allogeneic CAR-T cell product, in patients with R/R B-ALL. Eleven patients were treated with escalating doses of ThisCAR-T at 1 10 6 , 3 10 6 , and 5 10 6 cells/kg. One patient withdrew after infusion. Among the remaining ten patients, eight developed cytokine release syndrome, including seven with grade 1-2 and one with grade 3. Immune effector cell-associated neurotoxicity syndrome occurred in two patients (grade 1 and grade 4, respectively). No GVHD was observed. At day 28, 8 of 9 evaluable patients achieved complete remission (CR) or CR with incomplete hematologic recovery (CRi). At a median follow-up of 31 months, the 1-year progression-free survival and overall survival rates were 30% and 40%, respectively. ThisCAR-T demonstrated a favorable safety and promising antileukemic activity, supporting its potential as a novel therapy for R/R B-ALL.

论文信息

作者
Wu C、Xue L、Wu M、Li S、Xu Q、Liu K、Li H、Xu H
第一作者单位
Department of Hematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.China
通讯作者单位
Department of Hematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China. wangxingbing@ustc.edu.cn.China
文献类型
I 期临床试验
期刊
Bone marrow transplantation2026 Aug
原文标识
PubMed 42237011 · DOI 10.1038/s41409-026-02929-7