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:Development of tandem canine CAR T cells to enable comparative studies of aggressive B-cell lymphoma.
抗CD19CAR-T(CAR T)细胞对弥漫大B细胞淋巴瘤(DLBCL)具有令人期待的治疗潜力,但许多接受治疗的患者因CD19阴性克隆驱动的疾病进展而复发。
抗CD19CAR-T(CAR T)细胞对弥漫性大B细胞淋巴瘤(DLBCL)具有有前景的治疗潜力,但许多接受治疗的患者因CD19阴性克隆驱动的疾病进展而复发。共靶向CD19和CD20的串联CAR(TCAR)设计可能克服这一问题。然而,小鼠和灵长类模型不能完全再现人类疾病以及对CAR T疗法的临床反应,限制了临床前优化。此外,临床试验漫长且昂贵,进一步延迟了对新策略的评估。相比之下,犬DLBCL与人类疾病高度相似,并且在犬中开展CAR T试验可行,其临床后遗症与在人类CAR T治疗中观察到的相似。我们此前报道了接受CD20特异性CAR T细胞治疗的犬DLBCL患者出现CD20丢失,这与人类抗原逃逸机制一致。因此,我们假设可利用犬DLBCL加速更有效的基于TCAR的策略转化,使犬和人类患者均受益。为验证这一点,我们首先评估了犬淋巴瘤患者样本中CD19和CD20的表达。随后,我们开发了靶向CD19和CD20的犬TCAR,并评估了其针对犬DLBCL细胞的疗效和特异性。我们表明,犬B细胞淋巴瘤共表达CD19和CD20,其表达模式异质,与在人类中观察到的相似,并且经TCAR工程改造的犬T细胞能有效且特异性地清除表达CD19和/或CD20的细胞。我们的TCAR平台有望改善犬DLBCL的结局,并在进入人类试验前进一步优化下一代基于CAR的策略。
Anti-CD19 chimeric antigen receptor T (CAR T) cells have promising therapeutic potential for diffuse large B-cell lymphoma (DLBCL), yet many treated patients relapse due to progressive disease driven by CD19-negative clones. Tandem CAR (TCAR) designs co-targeting CD19 and CD20 may overcome this problem. However, murine and primate models do not fully recapitulate human disease and clinical responses to CAR T therapy, limiting preclinical optimization. Moreover, clinical trials are lengthy and costly, further delaying the evaluation of new strategies. By contrast, canine DLBCL closely resembles the human disease, and CAR T trials in canines are feasible, with clinical sequelae that mirror those observed in human CAR T therapy. We previously reported CD20 loss in canine DLBCL patients treated with CD20-specific CAR T cells, consistent with mechanisms of antigen escape in humans. We therefore hypothesized that canine DLBCL could be leveraged to accelerate the translation of more effective TCAR-based strategies, benefiting both canine and human patients. To test this, we first assessed the expression of CD19 and CD20 in canine lymphoma patient samples. We then developed canine TCARs directed against CD19 and CD20 and evaluated their efficacy and specificity against canine DLBCL cells. We show that canine B-cell lymphoma co-expresses CD19 and CD20 with heterogeneous expression patterns similar to those observed in humans, and that TCAR-engineered canine T cells effectively and specifically eliminate cells expressing CD19 and/or CD20. Our TCAR platform holds promise to improve outcomes in canine DLBCL and to further optimize next-generation CAR-based strategies before entering human trials.
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