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基于抗 CLL1 的嵌合抗原受体 T 细胞联合 4-1BB 或 CD28/CD27 共刺激结构域治疗儿童难治/复发急性髓系白血病。

Anti-CLL1-based CAR T-cells with 4-1-BB or CD28/CD27 stimulatory domains in treating childhood refractory/relapsed acute myeloid leukemia.

机构信息

Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China.

Guangzhou Medical University, Guangzhou, 511495, Guangdong, China.

出版信息

Cancer Med. 2023 Apr;12(8):9655-9661. doi: 10.1002/cam4.5916. Epub 2023 Apr 9.

Abstract

BACKGROUND

Though the efficacy of anti C-type lectin-like molecule-1 (CLL1) CAR T-cells in refractory/relapsed acute myeloid leukemia (R/R-AML) have been occasionally reported, the influence of co-stimulatory domain CAR T-cells is not investigated so far.

METHOD

Seven R/R-AML children treated with anti-CLL1 CAR T-cells were enrolled onto this preliminary comparison study. Among these seven patients, four received CD28/CD27-based CAR T-cells therapy, and three received 4-1BB-based CAR T-cells therapy.

RESULT

The overall response rates were 75% and 66.7% in CD28/CD27 and 4-1BB group respectively. All patients experienced grade 1 to 2 cytokine release syndrome, with only one patient experiencing grade 2 immune effector cell-associated neurotoxicity syndrome. The maximum CAR T-cells durations were 156 and 274 days for CD28/CD27 group and 4-1BB group respectively. The 1-yr overall survival rate was 57.1%.

CONCLUSIONS

A preliminary similar efficacy/safety index was observed in anti-CLL1-based CAR T-cells with 4-1BB or CD28/CD27 co-stimulatory elements in treating pediatric R/R-AML.

摘要

背景

尽管抗 C 型凝集素样分子-1(CLL1)嵌合抗原受体 T 细胞(CAR T 细胞)在难治/复发性急性髓系白血病(R/R-AML)中的疗效偶尔有报道,但目前尚未研究共刺激结构域 CAR T 细胞的影响。

方法

本初步比较研究纳入了 7 例接受抗 CLL1 CAR T 细胞治疗的 R/R-AML 儿童患者。在这 7 例患者中,4 例接受了 CD28/CD27 为基础的 CAR T 细胞治疗,3 例接受了 4-1BB 为基础的 CAR T 细胞治疗。

结果

CD28/CD27 组和 4-1BB 组的总体缓解率分别为 75%和 66.7%。所有患者均经历了 1 至 2 级细胞因子释放综合征,仅有 1 例患者经历了 2 级免疫效应细胞相关神经毒性综合征。CAR T 细胞的最大持续时间分别为 CD28/CD27 组的 156 天和 4-1BB 组的 274 天。1 年总生存率为 57.1%。

结论

在治疗儿科 R/R-AML 时,具有 4-1BB 或 CD28/CD27 共刺激元件的抗 CLL1 基 CAR T 细胞具有初步相似的疗效/安全性指数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04f9/10166968/9b38a5c54654/CAM4-12-9655-g002.jpg

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