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:PARP Inhibitors plus Anlotinib as Bridging Therapy for Armored CAR-T Cells in Ovarian Cancer Enhances Infiltration and Antitumor Efficacy.
我们的研究结果支持临床上可行的桥接疗法,具有增强卵巢癌 CAR-T 细胞疗法的转化潜力,并强调桥接疗法是改善 CAR-T 细胞在实体瘤中的获取和疗效的转化方法。
嵌合抗原受体 (CAR)-T 细胞疗法在大多数实体瘤中基本无效,部分原因是瘤内转运不足。在白细胞分离术和 CAR-T 细胞输注之间实施的桥接治疗,提供了一个独特的机会来控制疾病并预处理肿瘤微环境,而不会使 CAR-T 细胞直接暴露于伴随药物。在此,一种聚 (ADP-核糖) 聚合酶 (PARP) 抑制剂联合 anlotinib 被评估作为卵巢癌的桥接治疗。在携带卵巢肿瘤的免疫健全小鼠中,该方案诱导持久的瘤内 T 细胞积聚,与 cGAS-STING 通路激活、血管正常化和纤维状胶原沉积减少相关。此外,使用 bait-and-switch 策略工程化改造了 TGF 抵抗型、双靶点间皮素 (MSLN)/CD19 CAR-T 细胞。在 CAR-T 细胞输注前给予 niraparib 加 anlotinib 作为桥接治疗,增强了多种临床前卵巢癌模型中的 CAR-T 细胞浸润和抗肿瘤活性。这些发现为一项正在进行的 I 期临床试验 (NCT05141253) 提供了信息,该试验评估这些工程化 CAR-T 细胞在桥接治疗后用于难治性 MSLN 阳性实体瘤患者的安全性。总之,我们的发现支持一种临床上可操作的桥接治疗,具有增强卵巢癌中 CAR-T 细胞疗法的转化潜力,并强调桥接治疗作为一种转化方法,可改善实体瘤中 CAR-T 细胞的可及性和疗效。
Chimeric antigen receptor (CAR)-T cell therapy is largely ineffective in most solid tumors, partially because of inadequate intratumoral trafficking. Bridging therapy, administered between leukapheresis and CAR-T cell infusion, offers a distinct opportunity to control the disease and precondition the tumor microenvironment without directly exposing CAR-T cells to concomitant drugs. Here, a poly (ADP-ribose) polymerase (PARP) inhibitor combined with anlotinib is evaluated as bridging therapy for ovarian cancer. In immunocompetent mice bearing ovarian tumors, this regimen induces durable intratumoral T cell accumulation associated with activation of the cGAS-STING pathway, vascular normalization, and reduced fibrillar collagen deposition. Furthermore, TGF -resistant, dual-target mesothelin (MSLN)/CD19 CAR-T cells are engineered using a bait-and-switch strategy. Niraparib plus anlotinib administered as bridging therapy before CAR-T cell infusion enhances CAR-T cell infiltration and antitumor activity across multiple preclinical ovarian cancer models. These findings inform an ongoing phase I clinical trial (NCT05141253) evaluating the safety of these engineered CAR-T cells following bridging therapy in patients with refractory MSLN-positive solid tumors. Collectively, our findings support a clinically actionable bridging therapy with translational potential for potentiating CAR-T cell therapy in ovarian cancer and highlight bridging therapy as a translational approach to improve CAR-T cell access and efficacy in solid tumors.
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