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以双特异性抗体 XmAb 18968 靶向 CD38 治疗复发/难治性急性髓系白血病和 T 细胞急性淋巴细胞白血病患者

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.

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Targeting CD38 with bispecific antibody XmAb 18968 in patients with relapsed/refractory acute myeloid leukemia and T-cell acute lymphoblastic leukemia.

PubMed 2026/09/14(内容时间) Leukemia Q1 · IF 8.8(JCR 2025)

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研究概要

22 例 AML(n=13)和 T-ALL(n=9)患者入组,中位年龄 63 岁(范围 31-77)。

中文摘要

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)。

展开英文摘要原文

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).

论文信息

作者
Guru Murthy GS、Shah B、Badar T、Leonard J、DuVall A、Arana Yi C、Szabo A、Baim A
单位
Division of Hematology-Oncology, Medical College of Wisconsin, Milwaukee, WI, USA. gmurthy@mcw.edu.United States
期刊
Leukemia2026 Sep 14
原文标识
PubMed 42736326 · DOI 10.1038/s41375-026-03130-x