自体 T 细胞疗法治疗巨细胞病毒作为复发性胶质母细胞瘤的巩固治疗。

Autologous T-cell therapy for cytomegalovirus as a consolidative treatment for recurrent glioblastoma.

机构信息

Authors' Affiliations: QIMR Centre for Immunotherapy and Vaccine Development and Tumour Immunology Laboratory;

Cancer Drug Mechanisms Group;

出版信息

Cancer Res. 2014 Jul 1;74(13):3466-76. doi: 10.1158/0008-5472.CAN-14-0296. Epub 2014 May 4.

Abstract

Glioblastoma multiforme (GBM) is one of the most aggressive human brain malignancies. Even with optimal treatment, median survival is less than 6 months for patients with recurrent GBM. Immune-based therapies have the potential to improve patient outcome by supplementing standard treatment. Expression of human cytomegalovirus (CMV) antigens in GBM tissues provides the unique opportunity to target viral antigens for GBM therapy. Here, we report findings of a formal clinical assessment of safety and potential clinical efficacy of autologous CMV-specific T-cell therapy as a consolidative treatment for recurrent GBM. From a total of 19 patients with recurrent GBM, CMV-specific T cells were successfully expanded from 13 patients (68.4%), 11 of whom received up to four T-cell infusions. Combination therapy based on T-cell infusion and chemotherapy was well tolerated, and we detected only minor adverse events. The overall survival of these patients since first recurrence ranged from 133 to 2,428 days, with a median overall survival of 403 days. Most importantly, 4 of 10 patients that completed the treatment remained progression free during the study period. Furthermore, molecular profiling of CMV-specific T-cell therapy from these patients revealed distinct gene expression signatures, which correlated with their clinical response. Our study suggests that a combination therapy with autologous CMV-specific T cells and chemotherapy is a safe novel treatment option and may offer clinical benefit for patients with recurrent GBM.

摘要

多形性胶质母细胞瘤(GBM)是最具侵袭性的人类脑恶性肿瘤之一。即使采用最佳治疗方法,复发性 GBM 患者的中位生存期仍不足 6 个月。免疫疗法有可能通过补充标准治疗来改善患者的预后。GBM 组织中人类巨细胞病毒(CMV)抗原的表达为针对 GBM 治疗靶向病毒抗原提供了独特的机会。在这里,我们报告了一项关于自体 CMV 特异性 T 细胞疗法作为复发性 GBM 巩固治疗的安全性和潜在临床疗效的正式临床评估结果。在总共 19 例复发性 GBM 患者中,从 13 例患者(68.4%)中成功扩增了 CMV 特异性 T 细胞,其中 11 例患者接受了多达 4 次 T 细胞输注。基于 T 细胞输注和化疗的联合治疗耐受性良好,我们仅检测到轻微的不良反应。这些患者自首次复发后的总生存期为 133 至 2428 天,中位总生存期为 403 天。最重要的是,在研究期间,完成治疗的 10 名患者中有 4 名无进展。此外,对这些患者的 CMV 特异性 T 细胞治疗进行的分子分析显示出独特的基因表达特征,这些特征与他们的临床反应相关。我们的研究表明,自体 CMV 特异性 T 细胞和化疗的联合治疗是一种安全的新型治疗选择,可能为复发性 GBM 患者提供临床获益。

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