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白血病中死亡受体信号受损通过诱导 CAR T 细胞功能障碍导致抗原非依赖性耐药。

Impaired Death Receptor Signaling in Leukemia Causes Antigen-Independent Resistance by Inducing CAR T-cell Dysfunction.

机构信息

Division of Hematology/Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Center for Cellular Immunotherapies, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

出版信息

Cancer Discov. 2020 Apr;10(4):552-567. doi: 10.1158/2159-8290.CD-19-0813. Epub 2020 Jan 30.


DOI:10.1158/2159-8290.CD-19-0813
PMID:32001516
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7416790/
Abstract

Primary resistance to CD19-directed chimeric antigen receptor T-cell therapy (CART19) occurs in 10% to 20% of patients with acute lymphoblastic leukemia (ALL); however, the mechanisms of this resistance remain elusive. Using a genome-wide loss-of-function screen, we identified that impaired death receptor signaling in ALL led to rapidly progressive disease despite CART19 treatment. This was mediated by an inherent resistance to T-cell cytotoxicity that permitted antigen persistence and was subsequently magnified by the induction of CAR T-cell functional impairment. These findings were validated using samples from two CAR T-cell clinical trials in ALL, where we found that reduced expression of death receptor genes was associated with worse overall survival and reduced T-cell fitness. Our findings suggest that inherent dysregulation of death receptor signaling in ALL directly leads to CAR T-cell failure by impairing T-cell cytotoxicity and promoting progressive CAR T-cell dysfunction. SIGNIFICANCE: Resistance to CART19 is a significant barrier to efficacy in the treatment of B-cell malignancies. This work demonstrates that impaired death receptor signaling in tumor cells causes failed CART19 cytotoxicity and drives CART19 dysfunction, identifying a novel mechanism of antigen-independent resistance to CAR therapy..

摘要

原发性抵抗 CD19 导向嵌合抗原受体 T 细胞疗法(CART19)发生在 10%至 20%的急性淋巴细胞白血病(ALL)患者中;然而,这种抵抗的机制仍不清楚。使用全基因组功能丧失筛选,我们发现 ALL 中的死亡受体信号受损导致尽管进行了 CART19 治疗,但疾病仍迅速进展。这是由对 T 细胞细胞毒性的固有抵抗介导的,这种抵抗允许抗原持续存在,并随后通过诱导 CAR T 细胞功能障碍而放大。这些发现使用来自 ALL 的两个 CAR T 细胞临床试验中的样本得到了验证,我们发现死亡受体基因表达降低与总生存期较差和 T 细胞适应性降低相关。我们的研究结果表明,ALL 中死亡受体信号的固有失调通过损害 T 细胞细胞毒性并促进进行性 CAR T 细胞功能障碍,直接导致 CAR T 细胞失效。意义:对 CART19 的抵抗是治疗 B 细胞恶性肿瘤疗效的一个重大障碍。这项工作表明,肿瘤细胞中死亡受体信号的受损导致 CART19 细胞毒性失败,并驱动 CART19 功能障碍,确定了对 CAR 治疗的抗原非依赖性抵抗的新机制。

相似文献

[1]
Impaired Death Receptor Signaling in Leukemia Causes Antigen-Independent Resistance by Inducing CAR T-cell Dysfunction.

Cancer Discov. 2020-4

[2]
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[3]
Epigenetic Profiling and Response to CD19 Chimeric Antigen Receptor T-Cell Therapy in B-Cell Malignancies.

J Natl Cancer Inst. 2022-3-8

[4]
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[5]
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Front Immunol. 2020

[6]
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[7]
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[8]
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[9]
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[10]
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J Cancer Res Clin Oncol. 2020-5-24

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Ann Med Surg (Lond). 2025-7-18

[2]
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Oncogene. 2025-8-26

[3]
CAR T-cell immunotherapy as the next horizon in cancer eradication: current landscape, challenges, and future directions.

Med Oncol. 2025-8-6

[4]
CAR-engineered lymphocyte persistence is governed by a FAS ligand-FAS autoregulatory circuit.

Nat Cancer. 2025-7-22

[5]
Sustained and specific multiplexed immune checkpoint modulation in CAR T cells induced by targeted epigenome editing.

Mol Ther Nucleic Acids. 2025-7-1

[6]
Bioengineered immunocompetent preclinical trial-on-chip tool enables screening of CAR T cell therapy for leukaemia.

Nat Biomed Eng. 2025-7-1

[7]
Advances in the application of patient-derived xenograft models in acute leukemia resistance.

Cancer Drug Resist. 2025-5-28

[8]
Differential susceptibility and role for senescence in CART cells based on costimulatory domains.

Mol Cancer. 2025-6-10

[9]
Loss of p53 impairs death receptor expression and confers resistance to CD19 CAR T-cell therapy in BCP-ALL.

Blood Neoplasia. 2024-11-29

[10]
Durable response to CAR T is associated with elevated activation and clonotypic expansion of the cytotoxic native T cell repertoire.

Nat Commun. 2025-5-23

本文引用的文献

[1]
Optimizing Chimeric Antigen Receptor T-Cell Therapy for Adults With Acute Lymphoblastic Leukemia.

J Clin Oncol. 2019-12-9

[2]
Augmenting Immunotherapy Impact by Lowering Tumor TNF Cytotoxicity Threshold.

Cell. 2019-7-11

[3]
TOX reinforces the phenotype and longevity of exhausted T cells in chronic viral infection.

Nature. 2019-6-17

[4]
TOX is a critical regulator of tumour-specific T cell differentiation.

Nature. 2019-6-17

[5]
TOX transcriptionally and epigenetically programs CD8 T cell exhaustion.

Nature. 2019-6-17

[6]
Comprehensive Integration of Single-Cell Data.

Cell. 2019-6-6

[7]
TOX and TOX2 transcription factors cooperate with NR4A transcription factors to impose CD8 T cell exhaustion.

Proc Natl Acad Sci U S A. 2019-5-31

[8]
CD19 CAR T cell product and disease attributes predict leukemia remission durability.

J Clin Invest. 2019-3-12

[9]
NR4A transcription factors limit CAR T cell function in solid tumours.

Nature. 2019-2-27

[10]
Calibration of CAR activation potential directs alternative T cell fates and therapeutic potency.

Nat Med. 2018-12-17

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