抗 CD22/CD19 CAR-T 细胞疗法 CART2219.1 在成人和儿童复发/难治性 B-ALL 中的 I/II 期试验
A Phase I/II Trial of Anti-CD22/CD19 CAR-T Cell Therapy, CART2219.1, in Adult and Pediatric Relapsed/Refractory B-ALL.
在一项多中心I/II期试验中,所有患者(n=11;7名儿童,4名成人)在第28天均达到完全缓解(91%为微小残留病阴性)。
英文原题:Minor histocompatibility antigen TCR-T.
次要组织相容性抗原(MiHA)是同种异体造血细胞移植(allo-HCT)中由受者细胞上HLA分子呈递的多态性肽,来源于受者与供者之间存在遗传变异的蛋白质。
次要组织相容性抗原(MiHA)是异基因造血细胞移植(allo-HCT)中由受者细胞HLA分子呈递的多态性肽,来源于受者与供者之间存在遗传变异的蛋白质。allo-HCT后,造血限制性MiHA能够选择性靶向残留的受者来源造血细胞,包括恶性细胞。高亲和力MiHA特异性T细胞受体(TCR;TCR-T)工程化T细胞的进展正在推动MiHA T细胞免疫治疗的临床转化。HA-1和HA-2特异性TCR-T的早期试验证明其在高危或复发疾病中具有安全性、持久性和持久的抗白血病活性。为加速转化,该领域应扩大TCR-T开发至更多MiHA靶点以拓宽HLA和人群覆盖范围,将MiHA基因分型整合到供者选择中,并设计平台试验以纳入不同MiHA/HLA基因型的患者并高效测试联合治疗。MiHA导向的TCR-T代表一种基因精准的、可能成为常规HCT辅助手段的治疗策略,有望增强移植物抗白血病效应并改善无复发生存期。
Minor histocompatibility antigens (MiHA) are polymorphic peptides presented by HLA molecules on recipient cells in allogeneic hematopoietic cell transplantation (allo-HCT) and are derived from proteins with genetic variants that differ between recipient and donor. After allo-HCT, hematopoietic-restricted MiHA enable selective targeting of residual recipient-derived hematopoiesis, including malignant cells. Advances in engineering T cells with high-affinity, MiHA-specific T-cell receptors (TCR; TCR-T) are enabling clinical translation of MiHA T-cell immunotherapy. Early-phase trials of HA-1- and HA-2-specific TCR-T demonstrate safety, persistence, and durable antileukemic activity in high-risk or relapsed disease. To accelerate translation, the field should expand TCR-T development to additional MiHA targets to broaden HLA and population coverage, integrate MiHA genotyping into donor selection, and devise platform trials to include patients with various MiHA/HLA genotypes and to efficiently test combination therapies. MiHA-directed TCR-T represents a genetically precise, potentially routine HCT adjunct that promises to fortify graft-versus-leukemia effects and improve relapse-free survival.
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