Centre for Molecular Medicine Cologne and Department of Internal Medicine I, University of Cologne, Cologne, Germany.
Gene Ther. 2013 Feb;20(2):177-86. doi: 10.1038/gt.2012.21. Epub 2012 Mar 1.
A majority of cancer deaths are because of an uncontrolled relapse of the disease despite initial remission after therapy, asking for strategies to control tumour cells in the long term. Adoptive therapy with chimeric antigen receptor (CAR)-redirected T cells showed promising success in primary tumour elimination; the capacity of such engineered T cells to establish enduring tumour protection is currently a matter of discussion, in particular as most targeted 'tumour-associated antigens' are self-antigens. To address the issue in a clinically relevant model that closely mimics the human situation, we recorded rejection of carcinoembryonic antigen (CEA)-positive pancreatic tumours in the CEA transgenic mouse that expressed CEA as self-antigen in healthy cells of the gastrointestinal tract. Adoptive therapy with CD8(+) T cells, which were redirected by a CEA-specific, low-affinity CAR with CD3ζ endodomain, eliminated CEA(+) tumours in a primary response; cured mice produced an efficient recall response in the long term towards CEA(+) tumour cells upon rechallenge. Secondary tumour rejection was CEA specific, mediated by engineered T cells and did not require host T cells. No toxicity towards healthy tissues with CEA expression was recorded. Data indicate that adoptive therapy with engineered T cells can establish self-antigen-specific tumour protection in the long term without autoimmunity.
大多数癌症死亡是由于疾病在治疗后初始缓解后仍无法控制地复发,因此需要寻找长期控制肿瘤细胞的策略。嵌合抗原受体 (CAR)-导向的 T 细胞过继疗法在原发性肿瘤消除方面显示出有希望的成功;这些经过工程改造的 T 细胞建立持久肿瘤保护的能力目前是一个讨论的问题,特别是因为大多数靶向的“肿瘤相关抗原”都是自身抗原。为了解决在临床相关模型中的问题,该模型密切模拟人类情况,我们记录了在表达癌胚抗原 (CEA)作为胃肠道健康细胞自身抗原的 CEA 转基因小鼠中,对 CEA 阳性胰腺肿瘤的排斥。用一种 CEA 特异性、低亲和力的 CAR 与 CD3ζ 内源性结构域重新定向的 CD8(+) T 细胞过继疗法在原发性反应中消除了 CEA(+)肿瘤;经再挑战,治愈的小鼠长期对 CEA(+)肿瘤细胞产生有效的回忆反应。继发性肿瘤排斥是 CEA 特异性的,由工程 T 细胞介导,不需要宿主 T 细胞。未记录到针对表达 CEA 的健康组织的毒性。数据表明,经过基因工程改造的 T 细胞过继疗法可以在不产生自身免疫的情况下长期建立针对自身抗原的肿瘤保护。