Department of Hematology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, Chongqing, China.
Medical Center of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, Chongqing, China.
J Immunother Cancer. 2024 Nov 17;12(11):e009949. doi: 10.1136/jitc-2024-009949.
BACKGROUND: Chimeric antigen receptor T (CAR-T) cell therapy has been shown remarkable efficacy in the treatment of hematological malignancies in recent years. However, a considerable proportion of patients would experience tumor recurrence and deterioration. Insufficient CAR-T cell persistence is the major reason for relapse. Multiple strategies to enhance the long-term antitumor effects of CAR-T cells have been explored and developed. In this study, we focused on tyrosine kinase inhibitors (TKIs), which have emerged immunomodulatory potential besides direct tumoricidal effects. METHODS: Here, we screened 50 approved TKIs drugs and identified that afatinib (AFA) markedly enhanced the expressing of CD62L and inhibited reactive oxygen species level in T cells. And the underlying mechanisms of AFA medicating T cells were explored by detecting signal transduction, and metabolism pattern. Furthermore, we co-cultured AFA with CAR-T cells during the preparation stage and multianalyses of differentiation characteristics, metabolic profiling, and RNA sequencing revealed that AFA induce comprehensive metabolism remodeling and fate reprogramming. Based on it, we finally identified the antitumor efficacy of AFA-pretreatment CAR-T compared with negative-control CAR-T. RESULTS: We identified that AFA blocked the T-cell receptor (TCR) and phosphoinositide 3-kinase-protein kinase B-mechanistic target of rapamycin signaling pathways, induced metabolic reprogramming and modulated T-cell differentiation. When combined with CAR-T cells, AFA inhibited the exhaustion and enhanced the persistence and cytotoxicity. Our results revealed that the pretreatment of AFA enables to boost CAR-T cells with strong antitumor cytotoxicity in leukemia mouse model. CONCLUSIONS: Our study systematically demonstrated that AFA pretreatment effectively enhanced CAR-T cells antitumor performance, which presents a novel optimization strategy for potent and durable CAR-T cell therapy.
背景:嵌合抗原受体 T(CAR-T)细胞疗法近年来在治疗血液恶性肿瘤方面显示出显著疗效。然而,相当一部分患者会经历肿瘤复发和恶化。CAR-T 细胞持续存在不足是复发的主要原因。已经探索和开发了多种增强 CAR-T 细胞长期抗肿瘤作用的策略。在这项研究中,我们专注于酪氨酸激酶抑制剂(TKI),除了直接杀肿瘤作用外,它们还具有免疫调节潜力。
方法:在这里,我们筛选了 50 种批准的 TKI 药物,发现阿法替尼(AFA)显着增强了 T 细胞 CD62L 的表达并抑制了活性氧水平。并通过检测信号转导和代谢模式探索了 AFA 介导 T 细胞的潜在机制。此外,我们在制备阶段将 AFA 与 CAR-T 细胞共培养,并通过分化特征、代谢谱和 RNA 测序的综合分析,揭示了 AFA 诱导全面代谢重编程和命运重编程。在此基础上,我们最终确定了与阴性对照 CAR-T 相比,AFA 预处理 CAR-T 的抗肿瘤功效。
结果:我们发现 AFA 阻断了 T 细胞受体(TCR)和磷酸肌醇 3-激酶-蛋白激酶 B-雷帕霉素靶蛋白信号通路,诱导了代谢重编程并调节了 T 细胞分化。当与 CAR-T 细胞结合时,AFA 抑制了衰竭并增强了持久性和细胞毒性。我们的结果表明,AFA 预处理可使 CAR-T 细胞在白血病小鼠模型中具有强大的抗肿瘤细胞毒性。
结论:我们的研究系统地证明了 AFA 预处理可有效增强 CAR-T 细胞的抗肿瘤性能,为强大而持久的 CAR-T 细胞治疗提供了一种新的优化策略。
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