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病例报告:B7-H3嵌合抗原受体T细胞(CAR-T)疗法部分控制了一名基底细胞癌患者的肿瘤生长。

Case report: B7-H3 CAR-T therapy partially controls tumor growth in a basal cell carcinoma patient.

作者信息

Hu Gang, Li Guangchao, Wen Wei, Ding Wen, Zhou Zhao, Zheng Yongwei, Huang Taoyuan, Ren Junnan, Chen Rongyi, Zhu Dingheng, He Renliang, Liang Yunsheng, Luo Min

机构信息

Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China.

Research and Development Department Guangzhou Bio-Gene Technology Co., Ltd., Guangzhou, China.

出版信息

Front Oncol. 2022 Aug 17;12:956593. doi: 10.3389/fonc.2022.956593. eCollection 2022.

Abstract

B7-H3 is over-expressed in multiple types of solid tumors, making it an ideal target for chimeric antigen receptor (CAR)-T therapy. Here, we first report a case of multiple basal cell carcinoma (BCC) patient treated with humanized monoclonal anti-B7-H3 CAR-T cells through direct intratumoral injection. After three dose-escalated injections, the lesion in the abdomen decreased by 40% in volume, shrank from bulging to flat, but was not eradicated completely. The large lesion in the forehead became dry from original ulcer and bleeding. The adverse events observed were itching, myalgia, and redness. Immunohistochemistry analysis demonstrated that B7-H3-positive tumor cells and B7-H3 expression intensity were reduced after injections of CAR-T cells. The number of infiltrating CD3 T cells increased significantly but mainly located outside the tumor region. Subsequently, high levels of TGF-β in the tumor area were observed, suggesting that solid tumor microenvironment may hinder the infiltration and effect of CAR-T cells. In summary, in this particular case report, intratumoral injection of B7-H3 CAR-T cells partially controls tumor growth in the BCC patient with minor adverse events. The efficacy and safety of B7-H3 CAR-T therapy need to be further investigated with a larger cohort of patients. Although only one clinical case is reported here, the anti-B7-H3 CAR-T cell therapy should be considered as a treatment option for solid tumors in the future. This clinical trial was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn) with registration number ChiCTR2100044386.

摘要

B7-H3在多种实体瘤中过度表达,使其成为嵌合抗原受体(CAR)-T细胞疗法的理想靶点。在此,我们首次报告1例多发性基底细胞癌(BCC)患者通过直接瘤内注射人源化抗B7-H3单克隆CAR-T细胞进行治疗的病例。经过3次剂量递增注射后,腹部病灶体积缩小40%,从隆起变为扁平,但未完全根除。前额的大病灶从原来的溃疡出血变为干燥。观察到的不良事件有瘙痒、肌痛和发红。免疫组织化学分析表明,注射CAR-T细胞后,B7-H3阳性肿瘤细胞及B7-H3表达强度降低。浸润的CD3 T细胞数量显著增加,但主要位于肿瘤区域外。随后,观察到肿瘤区域有高水平的转化生长因子-β,提示实体瘤微环境可能会阻碍CAR-T细胞的浸润及作用。总之,在本病例报告中,瘤内注射B7-H3 CAR-T细胞可部分控制BCC患者的肿瘤生长,且不良事件轻微。B7-H3 CAR-T细胞疗法的疗效和安全性需要在更大规模的患者队列中进一步研究。尽管此处仅报告了1例临床病例,但抗B7-H3 CAR-T细胞疗法未来应被视为实体瘤的一种治疗选择。本临床试验已在中国临床试验注册中心(www.chictr.org.cn)注册,注册号为ChiCTR2100044386。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78a3/9428555/2d42e10b5230/fonc-12-956593-g001.jpg

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