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复发/难治性多发性骨髓瘤中同种异体靶向BCMA的CAR T细胞:1期UNIVERSAL试验中期结果

Allogeneic BCMA-targeting CAR T cells in relapsed/refractory multiple myeloma: phase 1 UNIVERSAL trial interim results.

作者信息

Mailankody Sham, Matous Jeffrey V, Chhabra Saurabh, Liedtke Michaela, Sidana Surbhi, Oluwole Olalekan O, Malik Shahbaz, Nath Rajneesh, Anwer Faiz, Cruz Jose Carlos, Htut Myo, Karski Erin E, Lovelace Wade, Dillon Myles, Butz Eric, Ying Wendy, Balakumaran Arun, Kumar Shaji K

机构信息

Myeloma Service and Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Department of Medicine, Weill Cornell Medical College, New York, NY, USA.

出版信息

Nat Med. 2023 Feb;29(2):422-429. doi: 10.1038/s41591-022-02182-7. Epub 2023 Jan 23.


DOI:10.1038/s41591-022-02182-7
PMID:36690811
Abstract

ALLO-715 is a first-in-class, allogeneic, anti-BCMA CAR T cell therapy engineered to abrogate graft-versus-host disease and minimize CAR T rejection. We evaluated escalating doses of ALLO-715 after lymphodepletion with an anti-CD52 antibody (ALLO-647)-containing regimen in 43 patients with relapsed/refractory multiple myeloma as part A of the ongoing first-in-human phase 1 UNIVERSAL trial. Primary objectives included determination of the safety and tolerability of ALLO-715 and the safety profile of the ALLO-647-containing lymphodepletion regimen. Key secondary endpoints were response rate and duration of response. Grade ≥3 adverse events were reported in 38 (88.0%) of patients. Cytokine release syndrome was observed in 24 patients (55.8%), with 1 grade ≥3 event (2.3%) and neurotoxicity in 6 patients (14%), with no grade ≥3 events. Infections occurred in 23 patients (53.5%), with 10 (23.3%) of grade ≥3. Overall, 24 patients (55.8%) had a response. Among patients treated with 320 × 10 CAR T cells and a fludarabine-, cyclophosphamide- and ALLO-647-based lymphodepletion regimen (n = 24), 17 (70.8%) had a response including 11 (45.8%) with very good partial response or better and 6 (25%) with a complete response/stringent complete response. The median duration of response was 8.3 months. These initial results support the feasibility and safety of allogeneic CAR T cell therapy for myeloma.

摘要

ALLO-715是一种首创的同种异体抗BCMA嵌合抗原受体(CAR)T细胞疗法,其设计目的是消除移植物抗宿主病并将CAR T细胞排斥反应降至最低。在一项正在进行的首例人体1期通用试验的A部分中,我们对43例复发/难治性多发性骨髓瘤患者采用含抗CD52抗体(ALLO-647)的方案进行淋巴细胞清除后,评估了递增剂量的ALLO-715。主要目标包括确定ALLO-715的安全性和耐受性以及含ALLO-647的淋巴细胞清除方案的安全性。关键次要终点是缓解率和缓解持续时间。38例(88.0%)患者报告了≥3级不良事件。24例患者(55.8%)出现细胞因子释放综合征,其中1例为≥3级事件(2.3%);6例患者(14%)出现神经毒性,无≥3级事件。23例患者(53.5%)发生感染,其中10例(23.3%)为≥3级。总体而言,24例患者(55.8%)有反应。在接受320×10个CAR T细胞以及基于氟达拉滨、环磷酰胺和ALLO-647的淋巴细胞清除方案治疗的患者中(n = 24),17例(70.8%)有反应,包括11例(45.8%)达到非常好的部分缓解或更好,6例(25%)达到完全缓解/严格完全缓解。中位缓解持续时间为8.3个月。这些初步结果支持了同种异体CAR T细胞疗法治疗骨髓瘤的可行性和安全性。

相似文献

[1]
Allogeneic BCMA-targeting CAR T cells in relapsed/refractory multiple myeloma: phase 1 UNIVERSAL trial interim results.

Nat Med. 2023-2

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Recent advances in universal chimeric antigen receptor T cell therapy.

J Hematol Oncol. 2025-8-29

[2]
Immunosenescence: signaling pathways, diseases and therapeutic targets.

Signal Transduct Target Ther. 2025-8-6

[3]
Glutamine-driven metabolic reprogramming promotes CAR-T cell function through mTOR-SREBP2 mediated HMGCS1 upregulation in ovarian cancer.

J Transl Med. 2025-7-17

[4]
Noncanonical and mortality-defining toxicities of CAR T cell therapy.

Nat Med. 2025-7-16

[5]
Revolutions at the frontline of multiple myeloma treatment: lessons and challenges to finding a cure.

Front Oncol. 2025-6-20

[6]
Hypoimmune CD19 CAR T cells treat allogeneic mice with features of spontaneous systemic lupus erythematosus.

iScience. 2025-5-31

[7]
Allogeneic CART progress: platforms, current progress and limitations.

Front Immunol. 2025-6-12

[8]
Low platelet counts and low CD4/CD8 ratios at apheresis increase the risk of CAR T-cell manufacturing failure in myeloma.

Blood Neoplasia. 2024-10-24

[9]
Allogeneic anti-CD19 CAR-T cells induce remission in refractory systemic lupus erythematosus.

Cell Res. 2025-5-8

[10]
Addressing graft-versus-host disease in allogeneic cell-based immunotherapy for cancer.

Exp Hematol Oncol. 2025-5-2

本文引用的文献

[1]
T-Cell Engagers - Modern Immune-Based Therapies for Multiple Myeloma.

N Engl J Med. 2022-8-11

[2]
Teclistamab in Relapsed or Refractory Multiple Myeloma.

N Engl J Med. 2022-8-11

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Promise and pitfalls of allogeneic chimeric antigen receptor therapy in plasma cell and lymphoid malignancies.

Br J Haematol. 2022-4

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Bispecific Antibodies in Multiple Myeloma: Present and Future.

Blood Cancer Discov. 2021-9

[5]
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Lancet. 2021-8-21

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Longer term outcomes with single-agent belantamab mafodotin in patients with relapsed or refractory multiple myeloma: 13-month follow-up from the pivotal DREAMM-2 study.

Cancer. 2021-11-15

[7]
Ciltacabtagene autoleucel, a B-cell maturation antigen-directed chimeric antigen receptor T-cell therapy in patients with relapsed or refractory multiple myeloma (CARTITUDE-1): a phase 1b/2 open-label study.

Lancet. 2021-7-24

[8]
Refractory and Resistant Cytomegalovirus After Hematopoietic Cell Transplant in the Letermovir Primary Prophylaxis Era.

Clin Infect Dis. 2021-10-20

[9]
Belantamab mafodotin in combination with novel agents in relapsed/refractory multiple myeloma: DREAMM-5 study design.

Future Oncol. 2021-6

[10]
Idecabtagene Vicleucel in Relapsed and Refractory Multiple Myeloma.

N Engl J Med. 2021-2-25

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