Allogene Therapeutics, Inc., 210 E. Grand Avenue, South San Francisco, CA 94080, USA.
Pfizer Cancer Immunology Discovery, Pfizer Worldwide Research and Development, 230 E. Grand Avenue, South San Francisco, CA 94080, USA.
Mol Ther. 2019 Jun 5;27(6):1126-1138. doi: 10.1016/j.ymthe.2019.04.001. Epub 2019 Apr 8.
Clinical success of autologous CD19-directed chimeric antigen receptor T cells (CAR Ts) in acute lymphoblastic leukemia and non-Hodgkin lymphoma suggests that CAR Ts may be a promising therapy for hematological malignancies, including multiple myeloma. However, autologous CAR T therapies have limitations that may impact clinical use, including lengthy vein-to-vein time and manufacturing constraints. Allogeneic CAR T (AlloCAR T) therapies may overcome these innate limitations of autologous CAR T therapies. Unlike autologous cell therapies, AlloCAR T therapies employ healthy donor T cells that are isolated in a manufacturing facility, engineered to express CARs with specificity for a tumor-associated antigen, and modified using gene-editing technology to limit T cell receptor (TCR)-mediated immune responses. Here, transcription activator-like effector nuclease (TALEN) gene editing of B cell maturation antigen (BCMA) CAR Ts was used to confer lymphodepletion resistance and reduced graft-versus-host disease (GvHD) potential. The safety profile of allogeneic BCMA CAR Ts was further enhanced by incorporating a CD20 mimotope-based intra-CAR off switch enabling effective CAR T elimination in the presence of rituximab. Allogeneic BCMA CAR Ts induced sustained antitumor responses in mice supplemented with human cytokines, and, most importantly, maintained their phenotype and potency after scale-up manufacturing. This novel off-the-shelf allogeneic BCMA CAR T product is a promising candidate for clinical evaluation.
自体 CD19 导向嵌合抗原受体 T 细胞(CAR T)在急性淋巴细胞白血病和非霍奇金淋巴瘤中的临床成功表明,CAR T 可能是一种有前途的血液恶性肿瘤治疗方法,包括多发性骨髓瘤。然而,自体 CAR T 疗法存在一些限制,可能会影响临床应用,包括冗长的静脉到静脉时间和制造限制。同种异体 CAR T(AlloCAR T)疗法可能克服自体 CAR T 疗法的这些固有限制。与自体细胞疗法不同,AlloCAR T 疗法采用健康供体 T 细胞,这些细胞在制造设施中分离,经过工程改造以表达对肿瘤相关抗原具有特异性的 CAR,并使用基因编辑技术进行修饰,以限制 T 细胞受体(TCR)介导的免疫反应。在这里,转录激活因子样效应物核酸酶(TALEN)基因编辑 B 细胞成熟抗原(BCMA)CAR T 用于赋予淋巴耗竭抗性和降低移植物抗宿主病(GvHD)潜力。同种异体 BCMA CAR T 的安全性通过掺入基于 CD20 模拟肽的内 CAR 关闭开关进一步增强,从而在存在利妥昔单抗的情况下有效消除 CAR T。同种异体 BCMA CAR T 在补充人细胞因子的小鼠中诱导持续的抗肿瘤反应,最重要的是,在扩大制造后保持其表型和效力。这种新型现成的同种异体 BCMA CAR T 产品是临床评估的有前途的候选者。
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