Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Leukoc Biol. 2022 Oct;112(4):913-918. doi: 10.1002/JLB.5MA0122-474R. Epub 2022 Mar 25.
CD19-chimeric antigen receptor (CAR)-based T-cell therapy has produced promising clinical responses in patients with relapsed or refractory B-cell malignancies. However, a significant portion of patients with mature B cell-derived malignancies, including chronic lymphocytic leukemia (CLL) and non-Hodgkin's lymphoma (NHL), do not respond to CD19-CAR-T cell therapy. Whether any characteristics and biomarkers intrinsic to cancer cells themselves can predict the CD19-CAR-T cell therapeutic response remains largely unknown. Surprisingly, by using experimental models, we show here that malignant B cells bearing CD21, a mature B cell marker, could not be efficiently killed by CD19-CAR-T cells. CD19, CD21, and CD81, together with CD225, form the B cell coreceptor complex that enhances B cell-mediated signaling. Our results indicated that CD21 affected the recognition of CD19-positive tumor cells by CD19-CAR-T cells and impaired the antitumor capacities of these effector cells. We have not only uncovered a mechanism underlying the impairment of CD19-CAR-T cells in mature B cell-derived CLL and NHL, but also proposed a pretreatment biomarker that may predict CD19-CAR-T cell therapeutic response, thus preventing foreseeable therapy failure and suggesting optimal personized therapies.
嵌合抗原受体(CAR)T 细胞疗法在复发性或难治性 B 细胞恶性肿瘤患者中产生了有前景的临床反应。然而,包括慢性淋巴细胞白血病(CLL)和非霍奇金淋巴瘤(NHL)在内的成熟 B 细胞来源恶性肿瘤患者中,相当一部分对 CD19-CAR-T 细胞治疗没有反应。癌症细胞本身是否存在任何固有特征和生物标志物可以预测 CD19-CAR-T 细胞治疗反应,在很大程度上仍然未知。令人惊讶的是,通过使用实验模型,我们在这里表明,携带成熟 B 细胞标志物 CD21 的恶性 B 细胞不能被 CD19-CAR-T 细胞有效杀伤。CD19、CD21 和 CD81 与 CD225 一起形成 B 细胞共受体复合物,增强 B 细胞介导的信号转导。我们的结果表明,CD21 影响 CD19-CAR-T 细胞对 CD19 阳性肿瘤细胞的识别,并损害这些效应细胞的抗肿瘤能力。我们不仅揭示了 CD19-CAR-T 细胞在成熟 B 细胞来源的 CLL 和 NHL 中受损的机制,还提出了一种预处理生物标志物,该标志物可能预测 CD19-CAR-T 细胞治疗反应,从而防止可预见的治疗失败,并建议最佳个性化治疗。
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