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:CD7 chimeric antigen receptor T cells in patients with relapsed or refractory CD7-positive acute myeloid leukemia.
CD7 chimeric antigen receptor T cells in patients with relapsed or refractory CD7-positive acute myeloid leukemia.
CD7在约30%的AML病例中表达,是一个有前景的靶点。
尽管 CAR-T 细胞疗法已经彻底改变了血液系统恶性肿瘤的治疗,但其在急性髓系白血病中的应用仍然具有挑战性。CD7 在大约 30% 的 AML 病例中表达,是一个有前景的靶点。这项 I 期临床试验(NCT04599556)评估了 CD7 靶向 CAR-T 细胞疗法在复发/难治性 CD7 阳性 AML 患者中的疗效。患者接受单次自体或供者来源 CD7 CAR-T 细胞输注,采用标准 3 + 3 剂量递增设计,设两个剂量水平。主要终点是剂量限制性毒性的发生率。共入组 14 例患者。治疗相关不良事件包括细胞因子释放综合征(92.9%)、3-4 级血细胞减少(100%)、1 级神经毒性(7.1%)和病毒再激活(78.6%)。客观缓解率为 92.3%,MRD 阴性率为 84.6%。尽管初始有缓解,7 例患者以 CD7 阴性疾病复发。在中位随访 172.5 天时,5 例患者仍处于缓解状态。3 年总生存率和无白血病生存率分别为 34.3% 和 34.1%。这些初步结果表明,CD7 CAR-T 细胞疗法在 R/R AML 患者中具有可控的安全性特征和初步疗效,支持在更大规模试验中进一步研究。
Although CAR-T cell therapy has revolutionized treatment for hematologic malignancies, its application in acute myeloid leukemia remains challenging. CD7 is expressed in approximately 30% of AML cases and represents a promising target. This phase I clinical trial (NCT04599556) evaluated CD7-targeted CAR-T cell therapy in patients with relapsed/refractory CD7-positive AML. Patients received a single infusion of autologous or donor-derived CD7 CAR-T cells using a standard 3 + 3 dose escalation design across two dose levels. The primary endpoint was the incidence of dose-limiting toxicities. Fourteen patients were enrolled. Treatment-related adverse events included cytokine release syndrome (92.9%), grade 3-4 cytopenia (100%), grade 1 neurotoxicity (7.1%), and viral reactivation (78.6%). The objective response rate was 92.3%, with an MRD-negative rate of 84.6%. Despite initial responses, seven patients relapsed with CD7-negative disease. At a median follow-up of 172.5 days, five patients remained in remission. The 3-year overall survival and leukemia-free survival rates were 34.3% and 34.1%, respectively. These initial results indicate that CD7 CAR-T cell therapy exhibits a manageable safety profile and preliminary efficacy in R/R AML patients, supporting further investigation in larger trials.
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