Bachiller Mireia, Barceló-Genestar Nina, Rodriguez-Garcia Alba, Alserawan Leticia, Dobaño-López Cèlia, Giménez-Alejandre Marta, Castellsagué Joan, Colell Salut, Otero-Mateo Marc, Antoñana-Vildosola Asier, Español-Rego Marta, Ferruz Noelia, Pascal Mariona, Martín-Antonio Beatriz, Anguela Xavier M, Fillat Cristina, Olesti Eulàlia, Calvo Gonzalo, Juan Manel, Delgado Julio, Pérez-Galán Patricia, Urbano-Ispizua Álvaro, Guedan Sonia
Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi Sunyer (FRCB-IDIBAPS), 08036 Barcelona, Spain.
Department of Immunology, Hospital Clínic, 08036 Barcelona, Spain.
Mol Ther. 2025 Jan 8;33(1):317-335. doi: 10.1016/j.ymthe.2024.11.028. Epub 2024 Nov 19.
CD19 CAR-T therapy has achieved remarkable responses in relapsed/refractory non-Hodgkin lymphoma (NHL). However, challenges persist, with refractory responses or relapses after CAR-T administration linked to CD19 loss or downregulation. Given the co-expression of CD19 and BCMA in NHL, we hypothesized that dual targeting could enhance long-term efficacy. We optimized different dual-targeting approaches, including co-transduction of two lentiviral vectors, bicistronic, tandem, and loop and pool strategies, based on our academic anti-CD19 (ARI0001) and anti-BCMA (ARI0002h) CAR-T cells. Comparison with anti-CD19/CD20 or anti-CD19/CD22 dual targeting was also performed. We demonstrate that anti-CD19/BCMA CAR-T cells can be effectively generated through the co-transduction of two lentiviral vectors after optimization to minimize competition for cellular resources. Co-transduced T cells, called ARI0003, effectively targeted NHL tumor cells with high avidity, outperforming anti-CD19 CAR-T cells and other dual-targeting approaches both in vitro and in vivo, particularly in low CD19 antigen density models. ARI0003 maintained effectiveness post-CD19 CAR-T treatment in xenograft models and in spheroids from relapsed CART-treated patients. ARI0003 CAR-T cells were effectively manufactured under Good Manufacturing Practice conditions, with a reduced risk of genotoxicity compared to other dual-targeting approaches. A first-in-human phase 1 clinical trial (CARTD-BG-01; this study was registered at ClinicalTrials.gov [NCT06097455]) has been initiated to evaluate the safety and efficacy of ARI0003 in NHL.
CD19嵌合抗原受体T细胞(CAR-T)疗法在复发/难治性非霍奇金淋巴瘤(NHL)中取得了显著疗效。然而,挑战依然存在,CAR-T治疗后出现难治性反应或复发与CD19缺失或下调有关。鉴于NHL中CD19和B细胞成熟抗原(BCMA)的共表达,我们推测双靶点靶向可能会提高长期疗效。基于我们的抗CD19(ARI0001)和抗BCMA(ARI0002h)CAR-T细胞,我们优化了不同的双靶点靶向方法,包括共转导两种慢病毒载体、双顺反子、串联、环化和混合策略。还进行了与抗CD19/CD20或抗CD19/CD22双靶点靶向的比较。我们证明,经过优化以最小化细胞资源竞争后,通过共转导两种慢病毒载体可以有效地产生抗CD19/BCMA CAR-T细胞。共转导的T细胞,称为ARI0003,以高亲和力有效靶向NHL肿瘤细胞,在体外和体内均优于抗CD19 CAR-T细胞和其他双靶点靶向方法,特别是在低CD19抗原密度模型中。在异种移植模型和复发的CAR-T治疗患者的球状体中,ARI0003在CD19 CAR-T治疗后仍保持有效性。ARI0003 CAR-T细胞在药品生产质量管理规范条件下能够有效制备,与其他双靶点靶向方法相比,基因毒性风险降低。一项针对人类的1期临床试验(CARTD-BG-01;该研究已在ClinicalTrials.gov上注册[NCT06097455])已启动,以评估ARI0003在NHL中的安全性和疗效。
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