采用经基因工程改造以分泌白细胞介素-2的肿瘤浸润淋巴细胞对黑色素瘤患者进行过继性细胞治疗。

Adoptive cell therapy for patients with melanoma, using tumor-infiltrating lymphocytes genetically engineered to secrete interleukin-2.

作者信息

Heemskerk Bianca, Liu Ke, Dudley Mark E, Johnson Laura A, Kaiser Andrew, Downey Stephanie, Zheng Zhili, Shelton Thomas E, Matsuda Kant, Robbins Paul F, Morgan Richard A, Rosenberg Steven A

机构信息

Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.

出版信息

Hum Gene Ther. 2008 May;19(5):496-510. doi: 10.1089/hum.2007.0171.

Abstract

Adoptive cell transfer of tumor-infiltrating lymphocytes (TILs) after lymphodepletion mediates regression in 50% of patients with metastatic melanoma. In vivo persistence and telomere length of the transferred cells correlate with antitumor response. In an attempt to prolong the in vivo survival of the transferred cells, TILs were genetically engineered to produce interleukin (IL)-2. In vitro, these transduced TILs secreted IL-2 while retaining tumor specificity and exhibited prolonged survival after IL-2 withdrawal. In a phase I/II clinical trial, seven evaluable patients received transduced TILs and one patient experienced a partial response associated with in vivo persistence of IL-2-transduced TILs in circulating lymphocytes. An additional five patients received transduced TILs in conjunction with IL-2 administration. Persistence of IL-2-transduced TILs was observed in three patients, including one partial responder. The transgene DNA as well as vector-derived IL2 mRNA could be detected for 4 months in responding patients. The low response rate in this trial was possibly due to a reduction in telomere length in cells as a result of prolonged in vitro culture. In this study, insertion of the IL-2 gene into antitumor TILs increased their ability to survive after IL-2 withdrawal in vitro but did not increase their in vivo persistence or clinical effectiveness.

摘要

淋巴细胞清除后进行肿瘤浸润淋巴细胞(TILs)的过继性细胞转移,可使50%的转移性黑色素瘤患者病情缓解。转移细胞在体内的持久性和端粒长度与抗肿瘤反应相关。为了延长转移细胞在体内的存活时间,对TILs进行基因工程改造以产生白细胞介素(IL)-2。在体外,这些转导的TILs分泌IL-2,同时保持肿瘤特异性,并且在撤除IL-2后存活时间延长。在一项I/II期临床试验中,7例可评估患者接受了转导的TILs,1例患者出现部分缓解,与循环淋巴细胞中IL-2转导的TILs在体内的持久性相关。另外5例患者在给予IL-2的同时接受了转导的TILs。在3例患者中观察到IL-2转导的TILs的持久性,其中包括1例部分缓解者。在有反应的患者中,转基因DNA以及载体衍生的IL2 mRNA可在4个月内检测到。该试验中的低反应率可能是由于体外长时间培养导致细胞端粒长度缩短。在本研究中,将IL-2基因插入抗肿瘤TILs可增加其在体外撤除IL-2后存活的能力,但并未增加其在体内的持久性或临床疗效。

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