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抗CD33嵌合抗原受体靶向治疗急性髓系白血病。

Anti-CD33 chimeric antigen receptor targeting of acute myeloid leukemia.

作者信息

O'Hear Carol, Heiber Joshua F, Schubert Ingo, Fey Georg, Geiger Terrence L

机构信息

St. Jude Children's Research Hospital, Department of Oncology, Memphis, TN, USA.

St. Jude Children's Research Hospital, Department of Pathology, Memphis, TN, USA.

出版信息

Haematologica. 2015 Mar;100(3):336-44. doi: 10.3324/haematol.2014.112748. Epub 2014 Dec 5.

Abstract

Current therapies for acute myeloid leukemia are associated with high failure and relapse rates. Adoptive immunotherapies, which have shown promise in the treatment of hematologic malignancies, have the potential to target acute myeloid leukemia through pathways that are distinct and complementary to current approaches. Here, we describe the development of a novel adoptive immunotherapy specific for this disease. We generated a second generation CD33-specific chimeric antigen receptor capable of redirecting cytolytic effector T cells against leukemic cells. CD33 is expressed in approximately 90% of acute myeloid leukemia cases and has demonstrated utility as a target of therapeutic antibodies. Chimeric antigen receptor-modified T cells efficiently killed leukemia cell lines and primary tumor cells in vitro. The anti-leukemia effect was CD33-specific, mediated through T-cell effector functions, and displayed tumor lysis at effector:target ratios as low as 1:20. Furthermore, the CD33-redirected T cells were effective in vivo, preventing the development of leukemia after prophylactic administration and delaying the progression of established disease in mice. These data provide pre-clinical validation of the effectiveness of a second-generation anti-CD33 chimeric antigen receptor therapy for acute myeloid leukemia, and support its continued development as a clinical therapeutic.

摘要

急性髓系白血病的现有疗法与高失败率和复发率相关。过继性免疫疗法在血液系统恶性肿瘤的治疗中显示出前景,它有可能通过与现有方法不同且互补的途径靶向急性髓系白血病。在此,我们描述了一种针对该疾病的新型过继性免疫疗法的开发。我们生成了第二代CD33特异性嵌合抗原受体,其能够使溶细胞效应T细胞重新定向以对抗白血病细胞。CD33在约90%的急性髓系白血病病例中表达,并已证明可作为治疗性抗体的靶点。嵌合抗原受体修饰的T细胞在体外有效杀伤白血病细胞系和原发性肿瘤细胞。抗白血病效应具有CD33特异性,通过T细胞效应功能介导,并且在效应细胞与靶细胞比例低至1:20时表现出肿瘤溶解作用。此外,CD33重定向的T细胞在体内有效,在预防性给药后可预防白血病的发生,并延缓小鼠中已建立疾病的进展。这些数据为第二代抗CD33嵌合抗原受体疗法治疗急性髓系白血病的有效性提供了临床前验证,并支持其作为临床治疗方法的持续开发。

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