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:CD70 Overexpression at Diagnosis Predicts Relapse and supports dual CD19-CD70 CAR-T Therapy in Follicular Lymphoma.
CD70 Overexpression at Diagnosis Predicts Relapse and supports dual CD19-CD70 CAR-T Therapy in Follicular Lymphoma.
这些发现为 CD19-CD70 双 CAR-T 疗法的临床开发提供了强有力的临床前理论依据,以改善高危 FL 和潜在的其他 B 细胞非霍奇金淋巴瘤的预后。
尽管一线免疫治疗可使大多数滤泡性淋巴瘤(FL)患者获得缓解,但仍需改进生物标志物和治疗策略,以识别和管理那些复发患者。我们在随访时间延长(>11年)、接受统一治疗的FL患者中,研究了诊断时的免疫微环境,比较了复发与无复发病例。转录组分析显示,复发患者中炎症反应通路富集,包括细胞因子过表达以及CD70上调,CD70是一种与免疫激活和炎症相关的分子。多重免疫荧光证实,诊断时肿瘤细胞以及CD8和CD4滤泡辅助性T(TFH)细胞中CD70过表达,并与较差的无进展生存期相关。功能研究显示,CD70肿瘤细胞增殖能力更强,并可诱导T细胞表达CD70,提示存在一个维持免疫激活的前馈环路。为了靶向这些细胞并增强当前的CAR-T方法,我们通过将CD19-CAR-T ARI-0001与基于CD27的抗CD70 CAR共转导,构建了CD19-CD70双嵌合抗原受体(CAR)T细胞。双CAR-T细胞对来源于患者的FL、弥漫性大B细胞淋巴瘤和套细胞淋巴瘤球状体表现出增强的体外细胞毒性。在FL异种移植模型中,与单靶点CAR-T细胞相比,双CAR-T治疗实现了更优的疾病控制,在脾脏和骨髓中诱导了完全肿瘤清除。总体而言,这些发现为CD19-CD70双CAR-T疗法的临床开发提供了强有力的临床前依据,以改善高危FL以及潜在其他B细胞非霍奇金淋巴瘤患者的结局。
Although first-line immunotherapy achieves remission in most patients with follicular lymphoma (FL), improved biomarkers and therapeutic strategies are required to identify and manage those who relapse. We investigated the immune microenvironment at diagnosis in uniformly treated FL patients with extended follow-up (>11 years), comparing relapsed and relapse-free cases. Transcriptomic profiling revealed enrichment of inflammatory response pathways in relapsed patients, including cytokine overexpression and upregulation of CD70, a molecule implicated in immune activation and inflammation. Multiplex immunofluorescence confirmed CD70 overexpression at diagnosis in tumor cells as well as in CD8 and CD4 T follicular helper (TFH) cells, correlating with inferior progression-free survival. Functional studies demonstrated that CD70 tumor cells were more proliferative and induced CD70 expression in T cells, suggesting a feed-forward loop sustaining immune activation. To target these cells and enhance current CAR-T approaches, we engineered dual CD19-CD70 chimeric antigen receptor (CAR) T cells by co-transducing the CD19-CAR-T ARI-0001 with a CD27-based anti-CD70 CAR. Dual CAR-T cells exhibited enhanced in vitro cytotoxicity against patient-derived spheroids of FL, diffuse large B-cell lymphoma, and mantle cell lymphoma. In FL xenograft models, dual CAR-T treatment achieved superior disease control compared to monotargeted CAR-T cells, inducing complete tumor clearance in spleen and bone marrow. Collectively, these findings provide strong preclinical rationale for the clinical development of CD19-CD70 dual CAR-T therapy to improve outcomes in high-risk FL and potentially other B-cell non-Hodgkin lymphomas.
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