耐拉皮辛多克隆Th1/Tc1细胞疗法 (RAPA-201) 在复发性,耐火性多发性髓瘤中安全诱导疾病缓解
Binod Dhakal1, Parameswaran Hari2,3, Saurabh Chhabra2,4
1Medical College of Wisconsin, Milwaukee, Wisconsin, USA bdhakal@mcw.edu.
Journal for immunotherapy of cancer
|January 28, 2025
概括
使用mTOR抑制和IFN-α极化进行的新型RAPA-201细胞疗法,对复发性多发性髓瘤显示有前途. 这种安全可行的治疗方法在64%的患者中实现了缓解,为晚期癌症提供了新的选择.
科学领域:
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
- 细胞疗法细胞疗法
背景情况:
- 通过mTOR抑制和IFN-α极化 (RAPA-201) 进行表观遗传重新编程的多克隆自主T细胞为癌症提供了一种新的采用性T细胞疗法.
- 活体 ex mTOR 抑制促进 T 中心记忆 (TCM) 细胞,而 IFN-α 两极化增强 I 型细胞因子,这两种已知可以提高采用 T 细胞治疗的疗效.
- 之前的研究评估了具有II型细胞因子表型的抗拉皮素T细胞在全基移植中.
研究的目的:
- 评估RAPA-201治疗在复发性,耐火性多发性骨髓瘤 (RRMM) 患者中的安全性和有效性.
- 为了评估RAPA-201与fludarabine-sparing低剂量宿主调节的结合.
主要方法:
- 一项临床试验 (NCT04176380) 涉及14名RRMM患者接受RAPA-201治疗.
- RAPA-201药物产品是多克隆的,富含TCM细胞,减少免疫检查点 (PD1,CD73,LAIR1),并分泌Th1细胞因子.
- 患者接受了平均三次RAPA-201输液以及化疗 (cyclophosphamide和pentostatin).
主要成果:
- 14名患者中有9名 (64%) 实现了疾病缓解,其中包括8个部分反应和一个严格的完整反应.
- 无进展生存时间的中位数为6.0个月.
- 没有将毒性归因于RAPA-201,没有观察到细胞因子释放综合征或免疫效应细胞相关的神经毒性综合征. 只有29%的患者经历了严重的不良事件.
结论:
- 使用mTOR抑制和IFN-α两极分化的RAPA-201的ex vivo制造产生了具有理想表型的产品.
- RAPA-201接受者保持T细胞计数和Th1细胞因子分泌,T细胞受体克隆性增加,可能增强抗瘤反应.
- 在RRMM患者中,RAPA-201疗法是可行的,安全的和有效的,可以诱导RRMM患者的缓解,克服了自主多克隆T细胞疗法的先前限制.
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