Flavell D J, Noss A, Pulford K A, Ling N, Flavell S U
University Department of Pathology, Southampton General Hospital, Hampshire, United Kingdom.
Cancer Res. 1997 Nov 1;57(21):4824-9.
We demonstrate in these preclinical studies that all severe combined immunodeficient mice injected with the human B-cell lymphoma cell line Ramos are cured when treated with a combination of anti-CD19, -CD22, and -CD38-saporin immunotoxins (ITs; termed 3BIT). Each component IT used individually did not cure the majority of animals but did significantly prolong their survival compared with PBS sham-treated controls, although the majority succumbed eventually to disease. The very significant improvement obtained with the three-IT combination 3BIT was not due to an antibody or antibody-plus-IT effect. We postulate that by targeting against these three cell surface molecules, we have effectively ensured delivery of saporin to each lymphoma cell with growth potential within the tumor, thus overcoming the problems of heterogeneity of target antigen expression that can limit the therapeutic efficacy of single-IT therapy or even two-IT combination therapy. These "proof of principle" findings have an obvious important bearing on antibody-based therapies for cancer and provide the rationale needed for the design and implementation of clinical trials with such combinations.
我们在这些临床前研究中证明,所有注射了人B细胞淋巴瘤细胞系Ramos的重度联合免疫缺陷小鼠,在接受抗CD19、抗CD22和抗CD38-皂草素免疫毒素(ITs;称为3BIT)联合治疗后均被治愈。单独使用每种成分IT不能治愈大多数动物,但与经PBS假处理的对照组相比,确实显著延长了它们的生存期,尽管大多数最终仍死于疾病。三IT组合3BIT所取得的非常显著的改善并非由于抗体或抗体加IT效应。我们推测,通过靶向这三种细胞表面分子,我们有效地确保了皂草素传递到肿瘤内每个具有生长潜力的淋巴瘤细胞,从而克服了靶抗原表达异质性问题,而这种问题可能会限制单一IT疗法甚至两IT联合疗法的治疗效果。这些“原理验证”发现对基于抗体的癌症治疗具有明显的重要意义,并为设计和实施此类联合疗法的临床试验提供了所需的理论依据。