CD371 向的 CAR T 细胞分泌介质素-18 呈现强烈扩张和清晰耐火性急性髓性白血病
Mark B Geyer1, Susan DeWolf1, Xiaoli Mi1
1Memorial Sloan Kettering Cancer Center, New York, New York, United States.
Blood
|August 27, 2025
概括
对急性骨髓性白血病 (AML) 的新型化学抗原受体 (CAR) T细胞疗法显示出前景. 针对CD371的低剂量CAR T细胞与IL-18分泌物在耐药患者中实现了AML清除.
科学领域:
- 癌症学
- 免疫疗法
- 血液学
背景情况:
- 与淋巴细胞恶性瘤相比,化学抗原受体 (CAR) T 细胞治疗在急性髓性白血病 (AML) 中表现出有限的成功.
- 在血液瘤学中,开发有效的CAR T细胞策略仍然是一个关键的挑战.
研究的目的:
- 在复发性/耐药性AML患者中评估一种新型CD371向的CART细胞疗法 (CD371/SAVVY/ IL-18 CAR) 的安全性和有效性.
- 在I期临床试验中评估CAR T细胞扩张,持久性和抗白血病活性.
主要方法:
- 在一期临床试验 (NCT06017258) 中,给5名复发性/ 耐药性AML的患者注射了CD371/ SAVVY/ IL-18 CAR T细胞.
- 患者接受一次注射剂量为3x10^4或3x10^5的CART细胞/ 千克.
- 进行单细胞分析以描述输液后的T细胞和NK细胞群.
主要成果:
- 在一次输液后,所有患者的CD371/SAVVY/IL-18CAR T细胞都显示出扩张.
- 在多种疗法和异构移植后,五分之三的患者获得了AML清除,没有移植对宿主疾病.
- 在较高剂量 (3x10^5 CAR- T细胞/ kg) 时,观察到剂量限制性毒性,包括长时间的细胞衰竭和严重的细胞释放综合征,导致剂量减少.
结论:
- 针对CD371的低剂量IL-18"装甲"CAR T细胞显示出对抗耐火性AML的显著活性.
- 这种方法有可能增强CAR T细胞的细胞毒性,并刺激内源性先天抗瘤免疫力.
- 这种有前途的AML免疫疗法需要进行进一步的研究以优化剂量.
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