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6B11-OCIK 过继细胞疗法治疗铂耐药复发性或难治性卵巢癌的初步安全性和潜在疗效。

Preliminary Safety and Potential Effect of 6B11-OCIK Adoptive Cell Therapy Against Platinum-Resistant Recurrent or Refractory Ovarian Cancer.

机构信息

Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.

Center of Gynecologic Oncology, Peking University People's Hospital, Beijing, China.

出版信息

Front Immunol. 2021 Aug 2;12:707468. doi: 10.3389/fimmu.2021.707468. eCollection 2021.

Abstract

Ovarian cancer is a leading cause of death among gynecological malignancies, and novel therapies are urgently needed. Here we report preliminary findings on the potential safety and efficacy of 6B11-OCIK, an adoptive cell therapy of autologous T cells induced by the humanized anti-idiotypic antibody 6B11 minibody plus dendritic cells and cytokines, against platinum-resistant recurrent or refractory ovarian cancer in three patients. We found that 6B11-OCIK treatment was safe and well tolerated after five cycles of intravenous infusion with an initial dose of 1-2×10 cells and a dose-climbing strategy. Hemoglobin, platelets, white cell count, creatinine or liver enzyme values, coagulation function, kidney and heart function were not significantly affected over the duration of therapy. Two of the three enrolled patients showed potentially drug-related grade 1 and 2 weakness, and no other adverse events were observed. Of the three enrolled patients, one had stable disease and two showed disease progression. The patient with favorable clinical efficacy had better immune response as measured by 6B11-OCIK proliferation capacity, activation ability of CD3+CD8+ tumor-specific cytotoxic T lymphocytes and CD3+CD56+ cytokine-induced killer cells, and tumor cell killing efficiency. Changes in circulating tumor cells after treatment were consistent with serum level CA125 in the patient with stable disease (both decreased), while differences were observed in the two patients with disease progression (increased CA125 in both and decreased CTC in the patient with better immune response), suggesting that variation of circulating tumor cells was more consistent with immune response and reflected efficacy directly. This preliminary study suggested that autologous 6B11-OCIK treatment was safe and had potential clinical efficacy against ovarian cancer. Patients with better immune response had more favorable efficacy. In addition to imaging, CA125 and immunophenotypes, CTC monitoring may represent a potential indicator of immunotherapy response.

摘要

卵巢癌是妇科恶性肿瘤死亡的主要原因,急需新的治疗方法。在这里,我们报告了三例采用自体 T 细胞经人源化抗独特型抗体 6B11 单抗和树突状细胞及细胞因子诱导的嵌合型 6B11-OCIK 过继细胞治疗铂耐药复发性或难治性卵巢癌的初步安全性和疗效。我们发现,在 5 个周期的静脉输注中,以 1-2×10 细胞的初始剂量和剂量爬坡策略进行治疗,6B11-OCIK 治疗是安全且耐受良好的。在治疗期间,血红蛋白、血小板、白细胞计数、肌酐或肝酶值、凝血功能、肾功能和心功能均无明显影响。入组的 3 例患者中有 2 例出现了潜在的与药物相关的 1 级和 2 级乏力,但未观察到其他不良反应。入组的 3 例患者中,1 例病情稳定,2 例病情进展。临床疗效良好的患者免疫反应较好,表现为 6B11-OCIK 增殖能力、CD3+CD8+肿瘤特异性细胞毒性 T 淋巴细胞和 CD3+CD56+细胞因子诱导的杀伤细胞的激活能力以及肿瘤细胞杀伤效率的提高。治疗后循环肿瘤细胞的变化与病情稳定患者的血清 CA125 水平一致(均下降),而病情进展的 2 例患者则存在差异(两者 CA125 均升高,免疫反应较好的患者 CTC 下降),提示循环肿瘤细胞的变化与免疫反应更一致,直接反映疗效。这项初步研究表明,自体 6B11-OCIK 治疗对卵巢癌安全且具有潜在的临床疗效。免疫反应较好的患者疗效更优。除了影像学、CA125 和免疫表型外,CTC 监测可能代表免疫治疗反应的一个潜在指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff5d/8366315/3da2d6d68617/fimmu-12-707468-g001.jpg

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