针对严重COVID-19的SARS-CoV-2特异性T细胞疗法:一个随机的1/2期试验
Anastasia Papadopoulou1, George Karavalakis1, Efthymia Papadopoulou2
1Hematopoietic Cell Transplantation Unit, Department of Hematology Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece.
Nature medicine
|July 17, 2023
概括
严重的COVID-19患者接受了SARS-CoV-2特异性T细胞 (CoV-2-STs) 以及标准护理,显示出改善的康复率和T细胞扩张. 这种采用免疫疗法是安全和可行的,这表明在未来的试验中潜在的临床益处.
科学领域:
- 免疫治疗是一种免疫疗法.
- 病毒学 病毒学
- 临床试验 临床试验
背景情况:
- 对于2019年严重的冠状病毒病 (COVID-19) 存在有限的治疗选择.
- 病毒特异性T细胞在其他情况下都显示出安全性和有效性.
- 严重急性呼吸道综合征冠状病毒2 (SARS-CoV-2) 特定的T细胞 (CoV-2-STs) 提供了一个潜在的治疗途径.
研究的目的:
- 评估Cov-2-STs与重症COVID-19患者的标准护理 (SoC) 结合的安全性和有效性.
- 为了比较Cov-2-ST + SoC与SoC单独的结果,在三角洲变种大流行期间.
- 为了评估治疗后的Cov-2-STs体内扩散.
主要方法:
- 一个随机 (2:1),开放标签的1/2期试验,涉及90名患有严重COVID-19的参与者.
- 参与者接受了Cov-2-STs + SoC或单独的SoC.
- 同主终点包括恢复时间,30天恢复率和Cov-2-ST扩张;60天的存活率是关键的次要终点.
主要成果:
- CoV-2-ST + SoC组表现出明显更高的康复率 (65%对38%,P=0.017) 和更快的中位康复时间 (11天对未达到,P=0.052).
- 在接受免疫治疗的患者中观察到Cov-2-STs的显著扩张 (P=0.047).
- 发现使用Cov-2-STs + SoC的治疗是安全的,耐受性良好.
结论:
- 采用现成的,部分与HLA匹配的Cov-2-STs的采用免疫疗法对于患有严重COVID-19的住院患者来说是可行的和安全的.
- 组合治疗显示了临床益处的初步证据,满足了初级疗效终点.
- 需要进行更大规模的临床试验来证实这些发现,并加强在严重的COVID-19管理中对Cov-2-STs的证据.
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