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表达 PD-1/CD28 嵌合开关受体的 CD19 CAR-T 作为不同 CD19 导向 CAR T 细胞疗法治疗后的 DLBCL 患者的挽救疗法。

CD19 CAR-T expressing PD-1/CD28 chimeric switch receptor as a salvage therapy for DLBCL patients treated with different CD19-directed CAR T-cell therapies.

机构信息

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.

出版信息

J Hematol Oncol. 2021 Feb 16;14(1):26. doi: 10.1186/s13045-021-01044-y.


DOI:10.1186/s13045-021-01044-y
PMID:33593414
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7885572/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8db/7885572/7372efa1b5f9/13045_2021_1044_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8db/7885572/7372efa1b5f9/13045_2021_1044_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8db/7885572/7372efa1b5f9/13045_2021_1044_Fig1_HTML.jpg

相似文献

[1]
CD19 CAR-T expressing PD-1/CD28 chimeric switch receptor as a salvage therapy for DLBCL patients treated with different CD19-directed CAR T-cell therapies.

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[6]
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[7]
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[9]
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[3]
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[4]
A predictive diagnostic model for refractory diffuse large B-cell lymphoma: a single-center retrospective cohort study.

Ann Hematol. 2025-3

[5]
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Bone Marrow Transplant. 2025-2

[6]
Application of CAR-T cell therapy in B-cell lymphoma: a meta-analysis of randomized controlled trials.

Clin Transl Oncol. 2025-6

[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Outcomes of patients with large B-cell lymphoma progressing after axicabtagene ciloleucel therapy.

Blood. 2021-4-1

[2]
Axicabtagene ciloleucel for relapsed or refractory lymphoma after prior treatment with a different CD19-directed CAR T-cell therapy.

Blood Adv. 2020-10-13

[3]
CD19-specific CAR T Cells that Express a PD-1/CD28 Chimeric Switch-Receptor are Effective in Patients with PD-L1-positive B-Cell Lymphoma.

Clin Cancer Res. 2021-1-15

[4]
Factors associated with outcomes after a second CD19-targeted CAR T-cell infusion for refractory B-cell malignancies.

Blood. 2021-1-21

[5]
CAR-T 19 combined with reduced-dose PD-1 blockade therapy for treatment of refractory follicular lymphoma: A case report.

Oncol Lett. 2019-11

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J Hematol Oncol. 2019-6-11

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CRISPR/Cas9-mediated PD-1 disruption enhances human mesothelin-targeted CAR T cell effector functions.

Cancer Immunol Immunother. 2018-12-6

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N Engl J Med. 2018-12-1

[10]
Axicabtagene Ciloleucel CAR T-Cell Therapy in Refractory Large B-Cell Lymphoma.

N Engl J Med. 2017-12-28

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