针对肺癌脑转移的 EpCAM 导向 CAR T 细胞的动力学和抗肿瘤作用。
dynamics and anti-tumor effects of EpCAM-directed CAR T-cells against brain metastases from lung cancer.
机构信息
Department of Neurology, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
Department of Neurosurgery, University Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.
出版信息
Oncoimmunology. 2023 Jan 13;12(1):2163781. doi: 10.1080/2162402X.2022.2163781. eCollection 2023.
Lung cancer patients are at risk for brain metastases and often succumb to their intracranial disease. Chimeric Antigen Receptor (CAR) T-cells emerged as a powerful cell-based immunotherapy for hematological malignancies; however, it remains unclear whether CAR T-cells represent a viable therapy for brain metastases. Here, we established a syngeneic orthotopic cerebral metastasis model in mice by combining a chronic cranial window with repetitive intracerebral two-photon laser scanning-microscopy. This approach enabled -characterization of fluorescent CAR T-cells and tumor cells on a single-cell level over weeks. Intraparenchymal injection of Lewis lung carcinoma cells (expressing the tumor cell-antigen EpCAM) was performed, and EpCAM-directed CAR T-cells were injected either intravenously or into the adjacent brain parenchyma. In mice receiving EpCAM-directed CAR T-cells intravenously, we neither observed substantial CAR T-cell accumulation within the tumor nor relevant anti-tumor effects. Local CAR T-cell injection, however, resulted in intratumoral CAR T-cell accumulation compared to controls treated with T-cells lacking a CAR. This finding was accompanied by reduced tumorous growth as determined per -microscopy and immunofluorescence of excised brains and also translated into prolonged survival. However, the intratumoral number of EpCAM-directed CAR T-cells decreased during the observation period, pointing toward insufficient persistence. No CNS-specific or systemic toxicities of EpCAM-directed CAR T-cells were observed in our fully immunocompetent model. Collectively, our findings indicate that locally (but not intravenously) injected CAR T-cells may safely induce relevant anti-tumor effects in brain metastases from lung cancer. Strategies improving the intratumoral CAR T-cell persistence may further boost the therapeutic success.
肺癌患者有脑转移的风险,并且常常死于颅内疾病。嵌合抗原受体 (CAR) T 细胞已成为血液恶性肿瘤的一种强大的细胞免疫疗法;然而,CAR T 细胞是否代表脑转移的可行治疗方法仍不清楚。在这里,我们通过将慢性颅窗与重复的脑内双光子激光扫描显微镜结合,在小鼠中建立了一种同源原位脑转移模型。这种方法使我们能够在数周内对荧光 CAR T 细胞和肿瘤细胞进行单细胞水平的特征分析。进行了表达肿瘤细胞抗原 EpCAM 的 Lewis 肺癌细胞的脑内注射,并且将 EpCAM 导向的 CAR T 细胞静脉内或脑实质内注射。在接受 EpCAM 导向的 CAR T 细胞静脉内注射的小鼠中,我们既没有观察到肿瘤内 CAR T 细胞的大量积聚,也没有观察到相关的抗肿瘤作用。然而,与缺乏 CAR 的 T 细胞治疗的对照组相比,局部 CAR T 细胞注射导致肿瘤内 CAR T 细胞的积聚。这一发现伴随着肿瘤生长的减少,这是通过显微镜检查和切除大脑的免疫荧光来确定的,并且还转化为生存时间的延长。然而,在观察期间,肿瘤内 EpCAM 导向的 CAR T 细胞数量减少,表明持续时间不足。在我们完全免疫功能正常的模型中,没有观察到 EpCAM 导向的 CAR T 细胞的中枢神经系统特异性或系统性毒性。总之,我们的研究结果表明,局部(而非静脉内)注射的 CAR T 细胞可能安全地诱导肺癌脑转移的相关抗肿瘤作用。提高肿瘤内 CAR T 细胞持续存在的策略可能进一步提高治疗效果。
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