Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA.
Clin Cancer Res. 2010 Dec 1;16(23):5852-61. doi: 10.1158/1078-0432.CCR-10-1280.
Immune responses to gene-modified cells are a concern in the field of human gene therapy, as they may impede effective treatment. We conducted 2 clinical trials in which cancer patients were treated with lymphocytes genetically engineered to express murine T-cell receptors (mTCR) specific for tumor-associated antigens p53 and gp100.
Twenty-six patients treated with autologous lymphocytes expressing mTCR had blood and serum samples available for analysis. Patient sera were assayed for the development of a humoral immune response. Adoptive cell transfer characteristics were analyzed to identify correlates to immune response.
Six of 26 (23%) patients' posttreatment sera exhibited specific binding of human anti-mTCR antibodies to lymphocytes transduced with the mTCR. Antibody development was found in both responding and nonresponding patients. The posttreatment sera of 3 of these 6 patients mediated a 60% to 99% inhibition of mTCR activity as measured by a reduction in antigen-specific interferon-γ release. Detailed analysis of posttreatment serum revealed that antibody binding was β-chain specific in 1 patient whereas it was α-chain specific in another.
A subset of patients treated with mTCR-engineered T cells developed antibodies directed to the mTCR variable regions and not to the constant region domains common to all mTCR. Overall, the development of a host immune response was not associated with the level of transduced cell persistence or response to therapy. In summary, patients treated with mTCR can develop an immune response to gene-modified cells in a minority of cases, but this may not affect clinical outcome.
在人类基因治疗领域,针对基因修饰细胞的免疫反应是一个令人关注的问题,因为它们可能会阻碍有效的治疗。我们进行了两项临床试验,将表达针对肿瘤相关抗原 p53 和 gp100 的鼠 T 细胞受体(mTCR)的基因修饰淋巴细胞用于癌症患者的治疗。
26 例接受表达 mTCR 的自体淋巴细胞治疗的患者有血液和血清样本可供分析。检测患者血清中是否存在体液免疫反应。分析过继细胞转移的特征,以确定与免疫反应相关的因素。
26 例患者中有 6 例(23%)治疗后的血清显示出人类抗 mTCR 抗体与转导 mTCR 的淋巴细胞特异性结合。在有反应和无反应的患者中均发现了抗体的产生。这 6 例患者中有 3 例的治疗后血清能够介导 mTCR 活性的 60%至 99%抑制,这通过减少抗原特异性干扰素-γ释放来衡量。对治疗后血清的详细分析表明,1 例患者的抗体结合是β链特异性的,而另 1 例患者的抗体结合是α链特异性的。
用 mTCR 工程化 T 细胞治疗的一部分患者产生了针对 mTCR 可变区而不是针对所有 mTCR 共有的恒定区结构域的抗体。总的来说,宿主免疫反应的发展与转导细胞的持续存在水平或对治疗的反应无关。总之,用 mTCR 治疗的患者在少数情况下会对基因修饰的细胞产生免疫反应,但这可能不会影响临床结果。