Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA.
Blood. 2012 May 3;119(18):4133-41. doi: 10.1182/blood-2011-12-400044. Epub 2012 Feb 21.
Adoptive cell therapy with tumor-targeted T cells is a promising approach to cancer therapy. Enhanced clinical outcome using this approach requires conditioning regimens with total body irradiation, lymphodepleting chemotherapy, and/or additional cytokine support. However, the need for prior conditioning precludes optimal application of this approach to a significant number of cancer patients intolerant to these regimens. Herein, we present preclinical studies demonstrating that treatment with CD19-specific, chimeric antigen receptor (CAR)-modified T cells that are further modified to constitutively secrete IL-12 are able to safely eradicate established disease in the absence of prior conditioning. We demonstrate in a novel syngeneic tumor model that tumor elimination requires both CD4(+) and CD8(+) T-cell subsets, autocrine IL-12 stimulation, and subsequent IFNγ secretion by the CAR(+) T cells. Importantly, IL-12-secreting, tumor-targeted T cells acquire intrinsic resistance to T regulatory cell-mediated inhibition. Based on these preclinical data, we anticipate that adoptive therapy using CAR-targeted T cells modified to secrete IL-12 will obviate or reduce the need for potentially hazardous conditioning regimens to achieve optimal antitumor responses in cancer patients.
过继性细胞疗法利用肿瘤靶向 T 细胞是癌症治疗的一种很有前途的方法。为了增强这种方法的临床疗效,需要使用全身照射、淋巴清除化疗和/或额外的细胞因子支持的预处理方案。然而,由于需要预先进行预处理,因此无法将这种方法最佳应用于大量不能耐受这些方案的癌症患者。在此,我们介绍了临床前研究,证明了用 CD19 特异性嵌合抗原受体(CAR)修饰的 T 细胞进行治疗,这些 T 细胞进一步修饰为持续分泌 IL-12,可在不进行预处理的情况下安全地消除已建立的疾病。我们在一种新的同种异体肿瘤模型中证明,肿瘤消除需要 CD4(+)和 CD8(+) T 细胞亚群、自分泌 IL-12 刺激以及随后 CAR(+) T 细胞分泌 IFNγ。重要的是,分泌 IL-12 的肿瘤靶向 T 细胞获得了对 T 调节细胞介导的抑制作用的内在抗性。基于这些临床前数据,我们预计,使用修饰为分泌 IL-12 的 CAR 靶向 T 细胞进行过继性治疗将消除或减少实现癌症患者最佳抗肿瘤反应所需的潜在危险预处理方案的必要性。
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