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校准的嵌合抗原受体(CAR)信号传导可实现大B细胞淋巴瘤的低剂量治疗。

Calibrated CAR Signaling Enables Low-Dose Therapy in Large B-Cell Lymphoma.

作者信息

Park Jae, Lia Palomba M, Perica Karlo, Devlin Sean, Shah Gunjan, Dahi Parastoo, Lin Richard, Salles Gilles, Scordo Michael, Nath Karthik, Valtis Yannis, Lynch Alec, Cathcart Elizabeth, Zhang Honglei, Schöder Heiko, Leithner Doris, Liotta Kelly, Yu Alina, Stocker Kelsey, Li Jia, Dey Agnish, Sellner Leopold, Singh Reshma, Sundaresan Varsha, Zhao Faye, Mansilla-Soto Jorge, He Changhao, Meyerson Joel, Hosszu Kinga, McAvoy Devin, Wang Xiuyan, Riviere Isabelle, Sadelain Michel

机构信息

Memorial Sloan Kettering Cancer Center.

MSKCC.

出版信息

Res Sq. 2024 Jul 2:rs.3.rs-4619285. doi: 10.21203/rs.3.rs-4619285/v1.

Abstract

We designed a CD19-targeted CAR comprising a calibrated signaling module, termed 1XX, that differs from that of conventional CD28/CD3z and 4-1BB/CD3z CARs. Here we report the first-in-human, phase 1 clinical trial of 19(T2)28z-1XX CAR T cells in relapsed/refractory large B-cell lymphoma. We hypothesized that 1XX CAR T cells may be effective at low doses and investigated 4 doubling dose levels starting from 25×10 CAR T cells. The overall response rate (ORR) was 82% and complete response (CR) rate 71% in the entire cohort (n=28) and 88% ORR and 75% CR in 16 patients treated at 25×10. With the median follow-up of 24 months, the 1-year EFS was 61% (95% CI: 45-82%). Overall, grade ≥3 CRS and ICANS rates were low at 4% and 7%. The calibrated potency of the 1XX CAR affords excellent efficacy at low cell doses and may benefit the treatment of other hematological malignancies, solid tumors and autoimmunity.

摘要

我们设计了一种靶向CD19的嵌合抗原受体(CAR),其包含一个经过校准的信号模块,称为1XX,它不同于传统的CD28/CD3ζ和4-1BB/CD3ζ CAR。在此,我们报告了19(T2)28z-1XX CAR T细胞用于复发/难治性大B细胞淋巴瘤的首次人体1期临床试验。我们假设1XX CAR T细胞可能在低剂量时有效,并研究了从25×10个CAR T细胞开始的4个加倍剂量水平。在整个队列(n=28)中,总体缓解率(ORR)为82%,完全缓解(CR)率为71%;在接受25×10个CAR T细胞治疗的16例患者中,ORR为88%,CR为75%。中位随访24个月时,1年无事件生存率(EFS)为61%(95%置信区间:45-82%)。总体而言,≥3级细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性综合征(ICANS)的发生率较低,分别为4%和7%。1XX CAR的校准效力在低细胞剂量下提供了优异的疗效,可能有益于其他血液系统恶性肿瘤、实体瘤和自身免疫性疾病的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc6e/11247921/252aabda661e/nihpp-rs4619285v1-f0001.jpg

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