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:Targeting CD38 with bispecific antibody XmAb 18968 in patients with relapsed/refractory acute myeloid leukemia and T-cell acute lymphoblastic leukemia.
Targeting CD38 with bispecific antibody XmAb 18968 in patients with relapsed/refractory acute myeloid leukemia and T-cell acute lymphoblastic leukemia.
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22 例 AML(n=13)和 T-ALL(n=9)患者入组,中位年龄 63 岁(范围 31-77)。
CD38 是一种在急性髓系白血病(AML)和 T 细胞急性淋巴细胞白血病(T-ALL)中高表达的跨膜糖蛋白。XmAb18968 是一种新型 CD38-CD3 双特异性 T 细胞衔接器,其 Fc 结构域经过改造以减少效应细胞的非选择性激活。在这项 1 期多中心临床试验中,我们评估了 XmAb18968 在复发/难治性(RR)AML 和 T-ALL 成人患者中的结局。共入组 22 例 AML(n = 13)和 T-ALL(n = 9)患者,中位年龄为 63 岁(范围 31-77)。既往治疗线数(中位 3,范围 1-8)包括 venetoclax(77.3%)、异基因 HCT(22.7%)、CD7 CAR-T 细胞治疗和 daratumumab(11.1%)。3 级不良事件包括贫血(14%)、中性粒细胞减少(18%)和血小板减少(14%)。未观察到 3 级细胞因子释放综合征或神经毒性。总体而言,17 例患者(AML = 11,ALL = 6)完成了至少一个周期的治疗。在 11 例 RR-AML 患者中,1 例达到部分缓解(PR),2 例达到 MRD 阴性完全缓解(CR)。在 6 例 RR-T-ALL 患者中,4 例疾病负荷获得有意义的改善,其中 1 例实现 MRD 清除。AML 的中位 OS 为 8.5 个月,T-ALL 为 8.7 个月。XmAb18968 安全且可耐受,并显示出令人鼓舞的初步疗效,支持在此背景下进一步研究 CD38 靶向治疗(NCT05038644)。
CD38 is a transmembrane glycoprotein highly expressed in acute myeloid leukemia (AML) and T-cell acute lymphoblastic leukemia (T-ALL). XmAb18968 is a novel CD38-CD3 bi-specific T-cell engager with Fc domain modified to reduce non-selective activation of effector cells. In this phase 1 multicenter clinical trial, we evaluated the outcomes of XmAb18968 in adults with relapsed/refractory (RR) AML and T-ALL. Twenty-two patients with AML (n = 13) and T-ALL (n = 9) with a median age of 63 years (range 31-77) were enrolled. Prior lines of therapy (median 3, range 1-8) included venetoclax (77.3%), allogeneic HCT (22.7%), CD7 CAR-T cell therapy and daratumumab (11.1%). Grade 3 adverse events included anemia (14%), neutropenia (18%), and thrombocytopenia (14%). No grade 3 cytokine release syndrome or neurotoxicity was seen. Overall, 17 patients (AML = 11, ALL = 6) completed at least one cycle of therapy. Among 11 patients with RR-AML, one achieved partial remission (PR) and two achieved MRD negative complete remission (CR). In 6 patients with RR-T-ALL, 4 achieved meaningful improvement in disease burden with 1 clearance of MRD. Median OS was 8.5 months in AML and 8.7 months in T-ALL. XmAb18968 is safe and tolerable with encouraging preliminary efficacy, supporting further investigation of CD38 targeting therapies in this setting (NCT05038644).
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