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在转移性胰腺癌和前列腺癌中,经利米度昔进行药理学激活的靶向前列腺干细胞抗原(PSCA)的BPX-601嵌合抗原受体(CAR)T细胞:一项1期剂量递增试验

PSCA-targeted BPX-601 CAR T cells with pharmacological activation by rimiducid in metastatic pancreatic and prostate cancer: a phase 1 dose escalation trial.

作者信息

Stein Mark N, Dumbrava Ecaterina E, Teply Benjamin A, Gergis Usama S, Guiterrez Martin E, Reshef Ran, Subudhi Sumit K, Jacquemont Céline F, Senesac Joseph H, Bayle J Henri, Scripture Charity D, Chatwal Monica S, Bilen Mehmet A, Stadler Walter M, Becerra Carlos R

机构信息

Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.

The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Nat Commun. 2024 Dec 30;15(1):10743. doi: 10.1038/s41467-024-53220-6.

Abstract

Here we report results of a phase 1 multi-institutional, open-label, dose-escalation trial (NCT02744287) of BPX-601, an investigational autologous PSCA-directed GoCAR-T® cell product containing an inducible MyD88/CD40 ON-switch responsive to the activating dimerizer rimiducid, in patients with metastatic pancreatic (mPDAC) or castration-resistant prostate cancer (mCRPC). Primary objectives were to evaluate safety and tolerability and determine the recommended phase 2 dose/schedule (RP2D). Secondary objectives included the assessment of efficacy and characterization of the pharmacokinetics of rimiducid. Thirty-three patients received BPX-601 with or without rimiducid, 24 patients with mPDAC and 9 with mCRPC. Two dose-limiting toxicities and two treatment-related deaths occurred in the highest-dose mCRPC cohort, after which the study was terminated, without determination of the RP2D. Two mCRPC patients experienced partial responses (one unconfirmed), and 56% of mCRPC patients achieved ≥50% reduction in prostate-specific antigen. BPX-601 cell expansion, long-term persistence in peripheral blood, and tumor infiltration were observed. Rimiducid increased circulating inflammatory cytokines/chemokines consistent with GoCAR-T® cell activation. These results suggest that pharmacological activation of GoCAR-T® cells is feasible and may offer a promising avenue to control chimeric antigen receptor-T cell activity with continued dose-optimization to improve tolerability.

摘要

在此,我们报告了一项1期多机构、开放标签、剂量递增试验(NCT02744287)的结果,该试验针对BPX - 601展开,BPX - 601是一种研究性自体PSCA导向的GoCAR - T®细胞产品,含有对激活二聚体利米度胺有反应的诱导型MyD88/CD40开关,用于治疗转移性胰腺癌(mPDAC)或去势抵抗性前列腺癌(mCRPC)患者。主要目标是评估安全性和耐受性,并确定推荐的2期剂量/给药方案(RP2D)。次要目标包括评估疗效以及对利米度胺的药代动力学进行表征。33名患者接受了含或不含利米度胺的BPX - 601治疗,其中24名患有mPDAC,9名患有mCRPC。在最高剂量的mCRPC队列中发生了2例剂量限制性毒性反应和2例与治疗相关的死亡,之后该研究终止,未确定RP2D。2例mCRPC患者出现部分缓解(1例未确认),56%的mCRPC患者前列腺特异性抗原降低≥50%。观察到BPX - 601细胞扩增、在外周血中的长期持久性以及肿瘤浸润。利米度胺增加了循环炎症细胞因子/趋化因子,这与GoCAR - T®细胞激活一致。这些结果表明,GoCAR - T®细胞的药理学激活是可行的,并且通过持续的剂量优化以提高耐受性,可能为控制嵌合抗原受体T细胞活性提供一条有前景的途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdda/11685978/4df618560c9c/41467_2024_53220_Fig1_HTML.jpg

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