CD19
嵌合抗原受体
医学
背景(考古学)
免疫疗法
免疫学
肿瘤科
癌症研究
抗原
生物
免疫系统
古生物学
作者
Gregory K. Chen,Chia-Hui Chen,Jessica Perazzelli,Stephan A. Grupp,David A. Barrett,Kai Tan
出处
期刊:Cancer immunology research
[American Association for Cancer Research]
日期:2022-10-18
卷期号:11 (1): 13-19
标识
DOI:10.1158/2326-6066.cir-22-0095
摘要
Abstract Chimeric antigen receptor (CAR) T-cell therapy targeting CD19 has been a clinical breakthrough for pediatric B-cell acute lymphoblastic leukemia (B-ALL), and loss of the CD19 target antigen on leukemic cells represents a major mechanism of relapse. Previous studies have observed CD19 mutations specific to CD19− relapses, and we sought to clarify and strengthen this relationship using deep whole-exome sequencing in leukemic cells expanded in a patient-derived xenograft. By assessing pre-treatment and relapse cells from 13 patients treated with CAR T-cell therapy, 8 of whom developed CD19− relapse and 5 of whom developed CD19+ relapse, we demonstrate that relapse-specific single-nucleotide variants and small indels with high allele frequency combined with deletions in the CD19 gene in a manner specific to those patients with CD19− relapse. Before CAR T-cell infusion, one patient was found to harbor a pre-existing CD19 deletion in the context of genomic instability, which likely represented the first hit leading to the patient's subsequent CD19− relapse. Across patients, preexisting mutations and genomic instability were not significant predictors of subsequent CD19− relapse across patients, with sample size as a potential limiting factor. Together, our results clarify and strengthen the relationship between genomic events and CD19− relapse, demonstrating this intriguing mechanism of resistance to a targeted cancer immunotherapy.
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