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:In vivo engineering of T cells with a synthetic cytokine receptor enables selective enrichment and expansion of anti-CD22 CAR T cells.
靶向CD19的体外制备嵌合抗原受体(CAR)T细胞已改变了B细胞恶性肿瘤患者的治疗策略,并在自身免疫性疾病中显示出有希望的结果。
靶向CD19的离体制造嵌合抗原受体(CAR)T细胞已改变了B细胞恶性肿瘤患者的治疗策略,并在自身免疫性疾病中显示出有希望的结果。然而尽管取得了成功,仍存在重大障碍阻碍患者获得这些疗法,包括其复杂的制造过程以及需要淋巴细胞清除性化疗。此外,许多接受离体制造CD19 CAR T细胞的患者未能获得持久缓解,提示CAR T细胞的扩增和持久性可能需要改善,和/或对于CD19靶向治疗后难治或复发的患者,可能需要靶向替代抗原的策略。Umoja正在开发一种表面工程化慢病毒载体平台,能够在无需淋巴细胞清除的情况下在体内生成CAR T细胞。UB-VV400递送由全人源抗CD22 CAR和雷帕霉素激活的细胞因子受体(RACR)组成的有效载荷,后者使CAR T细胞能够在雷帕霉素作用下优先扩增和富集。在此,我们描述临床前研究,证明UB-VV400生成的抗CD22 CAR T细胞可在体外和体内杀伤表达CD22的B细胞和肿瘤细胞,并且RACR的参与导致CAR T细胞在体内选择性扩增和富集,从而实现完全肿瘤清除和B细胞耗竭。
Ex vivo-manufactured chimeric antigen receptor (CAR) T cells targeting CD19 have transformed treatment strategies for patients with B cell malignancies and have shown promising results in autoimmune disease. Yet despite their success, significant barriers remain that impede patient access to these therapies, including their complex manufacturing and the need for lymphodepleting chemotherapy. Moreover, many patients who receive ex vivo-manufactured CD19 CAR T cells do not achieve durable responses, suggesting that the expansion and persistence of CAR T cells may need improvement, and/or that strategies targeting alternative antigens may be needed for patients who are refractory to or relapse following treatment with CD19-directed therapies. Umoja is developing a surface-engineered lentiviral vector platform capable of generating CAR T cells in vivo without lymphodepletion. UB-VV400 delivers a payload composed of a fully human anti-CD22 CAR and the rapamycin-activated cytokine receptor (RACR), which enable preferential expansion and enrichment of CAR T cells in response to rapamycin. Here, we describe preclinical studies demonstrating that UB-VV400 generates anti-CD22 CAR T cells that kill CD22-expressing B cells and tumor cells in vitro and in vivo, and that engagement of RACR results in the selective expansion and enrichment of CAR T cells in vivo leading to complete tumor clearance and B cell depletion.
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