Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, TX, USA.
Nat Commun. 2020 Jul 15;11(1):3549. doi: 10.1038/s41467-020-17175-8.
Refractory metastatic rhabdomyosarcoma is largely incurable. Here we analyze the response of a child with refractory bone marrow metastatic rhabdomyosarcoma to autologous HER2 CAR T cells. Three cycles of HER2 CAR T cells given after lymphodepleting chemotherapy induces remission which is consolidated with four more CAR T-cell infusions without lymphodepletion. Longitudinal immune-monitoring reveals remodeling of the T-cell receptor repertoire with immunodominant clones and serum autoantibodies reactive to oncogenic signaling pathway proteins. The disease relapses in the bone marrow at six months off-therapy. A second remission is achieved after one cycle of lymphodepletion and HER2 CAR T cells. Response consolidation with additional CAR T-cell infusions includes pembrolizumab to improve their efficacy. The patient described here is a participant in an ongoing phase I trial (NCT00902044; active, not recruiting), and is 20 months off T-cell infusions with no detectable disease at the time of this report.
难治性转移性横纹肌肉瘤基本无法治愈。在此,我们分析了一例难治性骨髓转移性横纹肌肉瘤患儿对自体 HER2 CAR T 细胞的反应。在淋巴细胞耗竭化疗后给予 3 个周期的 HER2 CAR T 细胞可诱导缓解,随后再给予 4 个周期无需淋巴细胞耗竭的 CAR T 细胞输注以巩固缓解。纵向免疫监测显示 T 细胞受体库发生重塑,出现免疫优势克隆和针对致癌信号通路蛋白的血清自身抗体。停药 6 个月时疾病在骨髓中复发。在接受一个周期的淋巴细胞耗竭和 HER2 CAR T 细胞治疗后,再次获得缓解。用额外的 CAR T 细胞输注进行缓解巩固包括使用 pembrolizumab 以提高其疗效。本文所描述的患者是正在进行的 I 期临床试验(NCT00902044;active, not recruiting)的参与者,在本报告时停止 T 细胞输注 20 个月,未检测到疾病。
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