Driving two chimeric antigen receptors (CARs) in a row to reduce antigen escape in B-cell acute lymphocytic leukaemia
Mené en Chine sur 81 patients pédiatriques atteints d'une leucémie lymphoïde aiguë à cellules B réfractaire ou récidivante (âge médian : 8 ans ; durée médiane de suivi : 17,7 mois), cet essai de phase II évalue l'efficacité, du point de vue du taux de réponse objective à 3 mois, et la toxicité d'une immunothérapie à base de lymphocytes CAR-T ciblant CD19 puis CD22
Chimeric antigen receptor (CAR)-modified T cells targeting CD19 have led to unprecedented complete remission rates of 70–98% in relapsed and refractory B-cell acute lymphocytic leukaemia. However, up to 50% of patients experience a disease relapse. 1 Given that antigen escape is a major contributor to relapse or lack of response after single-antigen targeted CARs, 2 it has been hypothesised that multi-antigen targeting could overcome escape, thereby improving remission durability. Clinical experience with CARs targeting both CD19 and CD22 is amassing rapidly. Despite this, an optimal dual-targeting approach has not been established.
The Lancet Oncology , commentaire, 2022