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:GPNMB-directed CAR T cell therapy against MiT/TFE-family fusion-driven solid tumors.
嵌合抗原受体(CAR)T细胞疗法在实体瘤中的应用受到安全、均匀表达的细胞表面靶点稀缺的限制。
实体瘤CAR-T细胞疗法受限于安全且均一表达的细胞表面靶点稀缺。本研究鉴定糖蛋白NMB(GPNMB)为一种由MiT/TFE家族融合驱动的蛋白,在原发和复发肺泡软组织肉瘤(ASPS)及易位性肾细胞癌中均呈高水平、均一且稳定表达。我们开发靶向GPNMB的CAR-T细胞产品GCAR1,在患者匹配的细胞、类器官和异种移植模型中显示强效活性。针对一项首次人体、开放标签、个体受试者试验(NCT07104682)中一名复发/难治、转移性ASPS患者的事后期中分析显示,GCAR1可使疾病稳定最长达3个月,同时多个非靶病灶消退(主要终点),且耐受性良好。GCAR1 T细胞在外周血中以多克隆群体扩增,并持续可检测1个月。空间转录组在一处治疗耐药病灶中识别出免疫抑制性生态位;在异种移植模型中,免疫检查点阻断与GCAR1具有协同作用。总体而言,这些数据为GCAR1治疗GPNMB表达型实体瘤提供概念验证,并更广泛地支持利用CAR-T细胞靶向由致癌基因融合驱动的细胞表面抗原。
Chimeric antigen receptor (CAR) T cell therapy for solid tumors is constrained by the scarcity of safe, uniformly expressed cell-surface targets. Here we identify glycoprotein NMB (GPNMB)-an MiT/TFE-family fusion-driven protein-as being highly, homogeneously and stably expressed in primary and relapsed alveolar soft-part sarcoma (ASPS) and translocation renal cell carcinoma. We develop a GPNMB-directed CAR T cell product, GCAR1, which demonstrates potent activity against patient-matched cells, organoids and xenograft models. Post hoc interim analysis of a first-in-human open-label, individual-participant trial ( NCT07104682 ) for a participant with relapsed/refractory, metastatic ASPS showed that GCAR1 induces stable disease for up to 3 months, accompanied by resolution of many nontarget lesions (primary endpoint), and is well tolerated. GCAR1 T cells expand in peripheral blood as a polyclonal population and remain detectable for 1 month. Spatial transcriptomics identified immunosuppressive niches in a treatment-resistant lesion and immune checkpoint blockade synergized with GCAR1 in a xenograft model. Altogether, our data provide a proof of concept for treating GPNMB-expressing solid tumors with GCAR1 and more broadly targeting surface antigens driven by oncogenic gene fusions with CAR T cell therapies.
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