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氟替妥单抗联合阿糖胞苷在儿童急性髓系白血病患者来源异种移植模型中的疗效

Efficacy of Flotetuzumab in Combination with Cytarabine in Patient-Derived Xenograft Models of Pediatric Acute Myeloid Leukemia.

作者信息

Barwe Sonali P, Kisielewski Anne, Bonvini Ezio, Muth John, Davidson-Moncada Jan, Kolb Edward Anders, Gopalakrishnapillai Anilkumar

机构信息

Nemours Centers for Childhood Cancer Research, Nemours Children's Hospital, Wilmington, DE 19803, USA.

Nemours Center for Cancer and Blood Disorders, Nemours Children's Hospital, Wilmington, DE 19803, USA.

出版信息

J Clin Med. 2022 Feb 28;11(5):1333. doi: 10.3390/jcm11051333.

Abstract

Children with acute myeloid leukemia (AML) have a poor prognosis despite the intensification of chemotherapy. Future efforts to improve outcomes should focus on more precise targeting of leukemia cells. CD123, or IL3RA, is expressed on the surface of nearly all pediatric AML samples and is a high-priority target for immunotherapy. The efficacy of an investigational dual-affinity retargeting antibody (DART) molecule (CD123 × CD3; MGD006 or flotetuzumab) was assessed in two distinct patient-derived xenograft (PDX) models of pediatric AML. MGD006 simultaneously binds to CD123 on target cells and CD3 on effector T cells, thereby activating T cells and redirecting them to induce cytotoxicity in target cells. The concurrent treatment of cytarabine and MGD006 was performed to determine the effect of cytarabine on T-cell counts and MGD006 activity. Treatment with MGD006 along with an allogeneic human T-cell infusion to act as effector cells induced durable responses in both PDX models, with CD123 positivity. This effect was sustained in mice treated with a combination of MGD006 and cytarabine in the presence of T cells. MGD006 enhanced T-cell proliferation and decreased the burden of AML blasts in the peripheral blood with or without cytarabine treatment. These data demonstrate the efficacy of MGD006 in prolonging survival in pediatric AML PDX models in the presence of effector T cells and show that the inclusion of cytarabine in the treatment regimen does not interfere with MGD006 activity.

摘要

尽管强化了化疗,但急性髓系白血病(AML)患儿的预后仍然很差。未来改善治疗结果的努力应集中在更精确地靶向白血病细胞上。CD123,即白细胞介素3受体(IL3RA),在几乎所有小儿AML样本的表面均有表达,是免疫治疗的高度优先靶点。在两种不同的小儿AML患者来源异种移植(PDX)模型中评估了一种研究性双亲和重定向抗体(DART)分子(CD123×CD3;MGD006或flotetuzumab)的疗效。MGD006同时与靶细胞上的CD123和效应T细胞上的CD3结合,从而激活T细胞并使其重新定向以诱导靶细胞的细胞毒性。进行阿糖胞苷和MGD006的联合治疗以确定阿糖胞苷对T细胞计数和MGD006活性的影响。用MGD006联合同种异体人T细胞输注作为效应细胞进行治疗,在两个具有CD123阳性的PDX模型中均诱导了持久反应。在用MGD006和阿糖胞苷联合治疗且存在T细胞的小鼠中,这种效应得以持续。无论有无阿糖胞苷治疗,MGD006均增强了T细胞增殖并降低了外周血中AML原始细胞的负担。这些数据证明了MGD006在存在效应T细胞的情况下延长小儿AML PDX模型生存期的疗效,并表明在治疗方案中加入阿糖胞苷不会干扰MGD006的活性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df0b/8911345/843ce24d652c/jcm-11-01333-g001.jpg

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