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用于治疗CD123阳性白血病的快速可切换通用嵌合抗原受体T细胞

Rapidly Switchable Universal CAR-T Cells for Treatment of CD123-Positive Leukemia.

作者信息

Loff Simon, Dietrich Josephine, Meyer Jan-Erik, Riewaldt Julia, Spehr Johannes, von Bonin Malte, Gründer Cordula, Swayampakula Mridula, Franke Kristin, Feldmann Anja, Bachmann Michael, Ehninger Gerhard, Ehninger Armin, Cartellieri Marc

机构信息

GEMoaB Monoclonals GmbH, 01307 Dresden, Germany.

Cellex Patient Treatment GmbH, 01307 Dresden, Germany.

出版信息

Mol Ther Oncolytics. 2020 Apr 29;17:408-420. doi: 10.1016/j.omto.2020.04.009. eCollection 2020 Jun 26.

Abstract

Chimeric antigen receptor T cells (CAR-T) targeting CD19 or B cell maturation antigen (BCMA) are highly effective against B cell malignancies. However, application of CAR-T to less differentially expressed targets remains a challenge due to lack of tumor-specific antigens and CAR-T controllability. CD123, a highly promising leukemia target, is expressed not only by leukemic and leukemia-initiating cells, but also by myeloid, hematopoietic progenitor, and certain endothelial cells. Thus, CAR-T lacking fine-tuned control mechanisms pose a high toxicity risk. To extend the CAR-T target landscape and widen the therapeutic window, we adapted our rapidly switchable universal CAR-T platform (UniCAR) to target CD123. UniCAR-T efficiently eradicated CD123 leukemia and . Activation, cytolytic response, and cytokine release were strictly dependent on the presence of the CD123-specific targeting module (TM123) with comparable efficacy to CD123-specific CAR-T . We further demonstrated a pre-clinical proof of concept for the safety-switch mechanism using a hematotoxicity mouse model wherein TM123-redirected UniCAR-T showed reversible toxicity toward hematopoietic cells compared to CD123 CAR-T. In conclusion, UniCAR-T maintain full anti-leukemic efficacy, while ensuring rapid controllability to improve safety and versatility of CD123-directed immunotherapy. The safety and efficacy of UniCAR-T in combination with TM123 will now be assessed in a phase I clinical trial (ClinicalTrials.gov: NCT04230265).

摘要

靶向CD19或B细胞成熟抗原(BCMA)的嵌合抗原受体T细胞(CAR-T)对B细胞恶性肿瘤具有高度疗效。然而,由于缺乏肿瘤特异性抗原和CAR-T的可控性,将CAR-T应用于差异表达较小的靶点仍然是一个挑战。CD123是一个非常有前景的白血病靶点,不仅在白血病细胞和白血病起始细胞中表达,也在髓系细胞、造血祖细胞和某些内皮细胞中表达。因此,缺乏精细调控机制的CAR-T具有很高的毒性风险。为了扩展CAR-T的靶点范围并拓宽治疗窗口,我们将快速可切换的通用CAR-T平台(UniCAR)进行改造以靶向CD123。UniCAR-T有效地根除了CD123白血病细胞。激活、细胞溶解反应和细胞因子释放严格依赖于CD123特异性靶向模块(TM123)的存在,其疗效与CD123特异性CAR-T相当。我们进一步使用血液毒性小鼠模型证明了安全开关机制的临床前概念验证,其中与CD123 CAR-T相比,TM123重定向的UniCAR-T对造血细胞表现出可逆毒性。总之,UniCAR-T在确保快速可控性以提高CD123导向免疫疗法的安全性和通用性的同时,维持了完全的抗白血病疗效。UniCAR-T与TM123联合使用的安全性和疗效现在将在一项I期临床试验中进行评估(ClinicalTrials.gov:NCT04230265)。

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