CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:A phase 1 trial of HPV16 E7 T-cell receptor-engineered T cells in patients with relapsed/refractory HPV16-positive cancers (KITE-439 trial).
A phase 1 trial of HPV16 E7 T-cell receptor-engineered T cells in patients with relapsed/refractory HPV16-positive cancers (KITE-439 trial).
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复发/难治性(r/r)HPV相关上皮癌患者预后较差。表达HPV16 E7特异性T细胞受体(TCR)的工程化T细胞可诱导肿瘤消退。
我们开展了一项KITE-439的1期试验,KITE-439是一种研究性自体T细胞产品,表达针对HPV16 E7的TCR,用于r/r HPV16+上皮癌患者。从白细胞单采外周血单个核细胞中选出的CD4+和CD8+ T细胞经抗CD3/抗CD28抗体刺激,随后在白细胞介素-7/15和AKT抑制剂存在下进行逆转录病毒转导和扩增。患者接受淋巴细胞清除性化疗(环磷酰胺30 mg/kg/天,共2天;氟达拉滨25 mg/m²/天,共5天),随后单次输注KITE-439,并每日给予IL-2(2.5×10⁵ IU/kg,最多7剂)。主要目标为安全性、耐受性和疗效;主要终点为剂量限制性毒性(DLT)。
8例HLA-A*02:01+患者接受了KITE-439(1×10⁶-1×10⁸ cells/kg)。试验期间未发生DLT。所有患者输注后7天内均在外周血中检测到KITE-439细胞。3例患者发生与KITE-439相关的1-2级细胞因子释放综合征(1-5天内缓解),4例发生KITE-439相关的1-2级神经系统事件(1天内缓解)。1例患者达到部分缓解(从第35天至第3个月),7例最佳疗效为疾病稳定。这些结果提示,KITE-439在治疗HPV相关上皮癌患者中具有可接受的安全性特征。仍需进一步研究以确定增强抗肿瘤活性所需的最佳生产条件和T细胞特征。
Patients with relapsed/refractory (r/r) HPV-associated epithelial cancers have a poor prognosis. Engineered T cells expressing a T cell receptor (TCR) specific for HPV16 E7 can induce tumor regression.
We conducted a Phase 1 trial of KITE-439, an investigational autologous T-cell product expressing TCR specific for HPV16 E7 in patients with r/r HPV16+ epithelial cancers. CD4+ and CD8+ T cells selected from leukapheresed peripheral blood mononuclear cells were stimulated with anti-CD3/anti-CD28 antibodies followed by retroviral transduction and expansion in the presence of interleukin-7/15 and an AKT inhibitor. Patients received lymphodepleting chemotherapy (cyclophosphamide 30 mg/kg/day for 2 days and fludarabine 25 mg/m 2 /day for 5 days) followed by a single infusion of KITE-439 with daily IL-2 (2. 5×10 5 IU/kg, up to 7 doses). The primary objectives were safety, tolerability, and efficacy; the primary endpoint was dose-limiting toxicities (DLTs).
Eight HLA-A*02:01 + patients received KITE-439 (1×10 6 -1×10 8 cells/kg). No DLTs occurred during the trial. In all patients, KITE-439 cells were detected in peripheral blood within 7 days post-infusion. Three patients experienced Grade 1-2 cytokine release syndrome related to KITE-439 (resolved within 1-5 days) and 4 had KITE-439-related Grade 1-2 neurologic events (resolved within a day).
One patient achieved a partial response (from Day 35 to Month 3) and 7 had a best response of stable disease. These results suggest that KITE-439 has an acceptable safety profile for the treatment of patients with HPV-associated epithelial cancers.
Further studies are needed to determine optimal manufacturing conditions and T-cell characteristics required for enhanced antitumor activity.
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