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:B7-H3 CAR T cells eradicate intrahepatic cholangiocarcinoma and induce durable response.
这些结果为在晚期 ICC 患者的临床试验中评估 iCas9.B7-H3 CAR T 细胞策略提供了有力依据。
背景:肝内胆管癌(ICC)是第二常见的原发性肝肿瘤,过去20年间发病率不断上升。手术可实现治愈,但多数患者确诊时已处于晚期,目前治疗选择疗效有限。B7-H3是一种免疫检查点分子,在ICC中的表达高于正常组织,因此是有吸引力的治疗靶点。本研究利用体内外模型考察B7-H3靶向CAR T细胞治疗ICC的疗效。 方法:从正常供者外周血单个核细胞中制备B7-H3 CAR T细胞,并以逆转录病毒载体转导编码第二代B7-H3特异性CAR构建体;该构建体还包括基于诱导型caspase 9(iCas9)的自杀安全开关。使用人ICC细胞系和患者来源器官型肿瘤球(PDOTS)在体外测试iCas9.B7-H3 CAR T细胞的抗肿瘤活性,并在ICC异种移植模型中进行体内评估。 结果:人ICC细胞系、患者切除的ICC样本和ICC组织芯片均显示B7-H3均一表达。iCas9.B7-H3 CAR T细胞在体外对多种患者来源ICC细胞系显示强效抗肿瘤活性。在临床前小鼠模型中,单次全身给药iCas9.B7-H3 CAR T细胞可使原位ICC肿瘤完全且持久消退,即使再次接种肿瘤亦然。通过脾脏注射和瘤内注射进行局部区域给药,其疗效与全身治疗同样有效。 结论:这些结果为在晚期ICC患者中开展iCas9.B7-H3 CAR T细胞策略临床试验提供了充分依据。
BACKGROUND: Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver tumor, with an increasing incidence over the past two decades. While surgery offers a curative option, most patients present with advanced disease, for which current therapeutic options are ineffective. B7-H3 is an immune checkpoint molecule that is overexpressed in ICC relative to normal tissue, making it an attractive therapeutic target. Utilizing in vitro and in vivo models, we investigated the efficacy of a B7-H3-targeted CAR T to treat ICC. METHODS: B7-H3 CAR T cells were generated from peripheral blood mononuclear cells of normal donors, transduced with a retroviral vector encoding a second generation B7-H3 specific CAR construct, incorporating an inducible caspase9 (iCas9) suicide gene-based safety switch. The anti-tumor activity of iCas9.B7-H3 CAR T cells against ICC was tested in vitro using human ICC cell lines and patient-derived organotypic tumor spheroids (PDOTS) and in vivo using xenograft models of ICC. RESULTS: Human ICC cell lines, resected ICC samples from patients, and ICC tissue microarrays demonstrate homogeneous expression of B7-H3. iCas9.B7-H3 CAR T cells demonstrated potent anti-tumor activity in vitro against multiple patient-derived ICC cell lines. A single systemic dose of iCas9.B7-H3 CAR T cells induced complete and sustained eradication of orthotopic ICC tumors in a preclinical mouse model, even after tumor re-challenge. Locoregional delivery of CAR T cells via splenic and intra-tumoral injection was equally effective as systemic therapy. CONCLUSIONS: These results provide a strong rationale for evaluating the iCas9.B7-H3 CAR T cell strategy in clinical trials for patients with advanced ICC.
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