Department of Hematology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Biochemistry and Molecular Biology, Peking University Cancer Hospital and Institute, Beijing, 100142, People's Republic of China.
J Hematol Oncol. 2021 Feb 16;14(1):26. doi: 10.1186/s13045-021-01044-y.
CD19-targeted chimeric antigen receptor T (CAR T) cell therapy is a promising option to treat relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). However, the majority of CAR T-treated patients will eventually progress and require salvage treatment, for which there is no current standard. In this study, we analyzed data from 6 patients with R/R DLBCL who experienced progression following CD19-CAR T therapy, and then received CD19-specific CAR T cells that express a PD-1/CD28 chimeric switch-receptor (CD19-PD-1/CD28-CAR T) as salvage therapy at our institution. After the second infusion of CAR T cells, 3 of 6 patients achieved complete remissions and the duration of the response of responsive patients ranged from 8 to 25 months. One patient showed a stable disease. In contrast, 2/6 patients died on 60 days because of progression disease. Importantly, no severe neurologic toxicity or cytokine release syndrome was observed. These data suggest that CD19-PD-1/CD28-CAR-T cells, a novel anti-CD19 CAR-T cell therapy, elicit a potent and durable anticancer response, and can be used in the post-CD19-CAR T failure setting.
CD19 靶向嵌合抗原受体 T(CAR T)细胞疗法是治疗复发/难治性弥漫性大 B 细胞淋巴瘤(R/R DLBCL)的一种有前途的选择。然而,大多数接受 CAR T 治疗的患者最终会进展并需要挽救性治疗,目前尚无标准治疗方法。在这项研究中,我们分析了在我们机构接受 CD19-CAR T 治疗后进展的 6 例 R/R DLBCL 患者的数据,然后接受了表达 PD-1/CD28 嵌合开关受体(CD19-PD-1/CD28-CAR T)的 CD19 特异性 CAR T 细胞作为挽救性治疗。在第二次输注 CAR T 细胞后,6 例患者中有 3 例达到完全缓解,且有反应的患者的反应持续时间为 8 至 25 个月。1 例患者病情稳定。相比之下,2/6 例患者因疾病进展在 60 天内死亡。重要的是,未观察到严重的神经毒性或细胞因子释放综合征。这些数据表明,CD19-PD-1/CD28-CAR-T 细胞,一种新型的抗 CD19 CAR-T 细胞疗法,可引发强大且持久的抗癌反应,并可在 CD19-CAR T 失败后使用。
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