Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, PR China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China.
Signal Transduct Target Ther. 2023 Dec 25;8(1):457. doi: 10.1038/s41392-023-01708-w.
Chimeric antigen receptor (CAR) T-cell therapy has demonstrated clinical response in treating both hematologic malignancies and solid tumors. Although instances of rapid tumor remissions have been observed in animal models and clinical trials, tumor relapses occur with multiple therapeutic resistance mechanisms. Furthermore, while the mechanisms underlying the long-term therapeutic resistance are well-known, short-term adaptation remains less understood. However, more views shed light on short-term adaptation and hold that it provides an opportunity window for long-term resistance. In this study, we explore a previously unreported mechanism in which tumor cells employ trogocytosis to acquire CAR molecules from CAR-T cells, a reversal of previously documented processes. This mechanism results in the depletion of CAR molecules and subsequent CAR-T cell dysfunction, also leading to short-term antigen loss and antigen masking. Such type of intercellular communication is independent of CAR downstream signaling, CAR-T cell condition, target antigen, and tumor cell type. However, it is mainly dependent on antigen density and CAR sensitivity, and is associated with tumor cell cholesterol metabolism. Partial mitigation of this trogocytosis-induced CAR molecule transfer can be achieved by adaptively administering CAR-T cells with antigen density-individualized CAR sensitivities. Together, our study reveals a dynamic process of CAR molecule transfer and refining the framework of clinical CAR-T therapy for solid tumors.
嵌合抗原受体 (CAR) T 细胞疗法已在治疗血液系统恶性肿瘤和实体瘤方面显示出临床疗效。虽然在动物模型和临床试验中观察到肿瘤迅速消退的情况,但肿瘤复发与多种治疗耐药机制有关。此外,尽管长期治疗耐药的机制众所周知,但短期适应性仍知之甚少。然而,更多的观点揭示了短期适应性,并认为它为长期耐药提供了一个机会窗口。在这项研究中,我们探讨了一种以前未报道的机制,即肿瘤细胞通过 trogocytosis 从 CAR-T 细胞中获得 CAR 分子,这是以前记录的过程的逆转。这种机制导致 CAR 分子耗竭和随后的 CAR-T 细胞功能障碍,也导致短期抗原丢失和抗原掩蔽。这种细胞间通讯独立于 CAR 下游信号、CAR-T 细胞状态、靶抗原和肿瘤细胞类型。然而,它主要取决于抗原密度和 CAR 敏感性,并与肿瘤细胞胆固醇代谢有关。通过适应性地用抗原密度个体化的 CAR 敏感性给予 CAR-T 细胞,可以部分减轻这种 trogocytosis 诱导的 CAR 分子转移。总之,我们的研究揭示了 CAR 分子转移的动态过程,并完善了实体瘤临床 CAR-T 治疗的框架。