Till Brian G, Jensen Michael C, Wang Jinjuan, Chen Eric Y, Wood Brent L, Greisman Harvey A, Qian Xiaojun, James Scott E, Raubitschek Andrew, Forman Stephen J, Gopal Ajay K, Pagel John M, Lindgren Catherine G, Greenberg Philip D, Riddell Stanley R, Press Oliver W
Clinical Research Division of the Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
Blood. 2008 Sep 15;112(6):2261-71. doi: 10.1182/blood-2007-12-128843. Epub 2008 May 28.
Adoptive immunotherapy with T cells expressing a tumor-specific chimeric T-cell receptor is a promising approach to cancer therapy that has not previously been explored for the treatment of lymphoma in human subjects. We report the results of a proof-of-concept clinical trial in which patients with relapsed or refractory indolent B-cell lymphoma or mantle cell lymphoma were treated with autologous T cells genetically modified by electroporation with a vector plasmid encoding a CD20-specific chimeric T-cell receptor and neomycin resistance gene. Transfected cells were immunophenotypically similar to CD8(+) effector cells and showed CD20-specific cytotoxicity in vitro. Seven patients received a total of 20 T-cell infusions, with minimal toxicities. Modified T cells persisted in vivo 1 to 3 weeks in the first 3 patients, who received T cells produced by limiting dilution methods, but persisted 5 to 9 weeks in the next 4 patients who received T cells produced in bulk cultures followed by 14 days of low-dose subcutaneous interleukin-2 (IL-2) injections. Of the 7 treated patients, 2 maintained a previous complete response, 1 achieved a partial response, and 4 had stable disease. These results show the safety, feasibility, and potential antitumor activity of adoptive T-cell therapy using this approach. This trial was registered at www.clinicaltrials.gov as #NCT00012207.
采用表达肿瘤特异性嵌合T细胞受体的T细胞进行过继性免疫治疗是一种很有前景的癌症治疗方法,此前尚未用于人类淋巴瘤的治疗。我们报告了一项概念验证性临床试验的结果,在该试验中,复发或难治性惰性B细胞淋巴瘤或套细胞淋巴瘤患者接受了经电穿孔用编码CD20特异性嵌合T细胞受体和新霉素抗性基因的载体质粒进行基因改造的自体T细胞治疗。转染细胞在免疫表型上与CD8(+)效应细胞相似,并在体外显示出CD20特异性细胞毒性。7名患者共接受了20次T细胞输注,毒性极小。在前3名接受有限稀释法产生的T细胞的患者中,改造后的T细胞在体内持续存在1至3周,但在接下来4名接受批量培养产生的T细胞并随后进行14天低剂量皮下注射白细胞介素-2(IL-2)的患者中,T细胞持续存在5至9周。在7名接受治疗的患者中,2名维持了先前的完全缓解,1名达到部分缓解,4名病情稳定。这些结果表明了使用这种方法进行过继性T细胞治疗的安全性、可行性和潜在的抗肿瘤活性。该试验已在www.clinicaltrials.gov上注册,编号为#NCT00012207。
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