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CAR-NK是否优于CAR-T细胞免疫疗法? [复制链接]

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楼主
发表于 2015-11-11 10:59 |只看该作者 |倒序浏览 |打印
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3 l1 N; X/ q* J3 zOn December 15, 2014, Patrick Soon Shiong, the richest physician in the world, acquired 19.9% of Sorrento Therapeutics (NASDAQ: SRNE)’s equity at $5.80 per share (about 41.7 million). Four days later, Sorrento and Conkwest announced an agreement to co-develop CAR-NK immunotherapy. Sorrento’s stock price reached a high of $11.38 on January 15, 2015.
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CAR-T cell immunotherapy has been regarded as one of the most compelling breakthroughs in cancer treatment in recent years. Companies working on CAR-T (e.g., JUNO, KITE, BLCM, BLUE, ZIOP) are red hot at present. Sorrento/Conkwest is developing CAR-expressing NK cells rather than T cells to kill cancer cells. How about CAR-TNK compares to CAR-T?" w  R2 H% g- b
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Here is a comparison published in OncoImmunology[1]. The author, Hans Klingemann, is the inventor of the NK-92 cell line and co-founded ZelleRx in 2002, which was renamed Conkwest in 2010. CAR-NK has many several advantages over CAR-T:
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* d* D7 q' M( L' o5 G; o(1) CAR-NK cells don’t produce IL-6 which is associated with the cytokine release syndrome. A series of patient deaths in the trials of CAR-T were linked to unusually high levels of IL-6.+ G  p2 a6 M% ^) ^: d
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(2) CAR-NK cells disappear relatively rapidly from the circulation owing to their limited lifespan. There is no concern about persisting CAR-associated side effects. Whereas Juno Therapeutics has to insert EGFRt gene into the CAR-T cells to control them.
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(3) NK cells are known as serial killers which diligently moves from one target to the next one, killing on as many as 7-10 cells.; P; }) n  S: z; B6 R

; a4 z6 G& w" Z3 V1 A) \$ ]; y(4) The transfection efficiency of NK-92 cells is about 50%, even with non-viral methods. Avoiding viral vectors eliminates the risks of oncogene activation and insertional mutagenesis.
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! P  j- w9 b0 C8 w( M/ x" A(5) CAR-NK cells can also be produced in large scaleunder GMP conditions. Moerover, it may be used in the setting of allogeneic transplantation.0 q) c- f' h- u4 ~1 G
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Naturally, only about 10% of circulating lymphocytes are NK cells. The activation of NK cells is determined by the balance of inhibitory and activating receptor stimulation. MHC class I molecules in normal cells inhibit the activation of NK cells.
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Natural NK cells do not express antigen specific receptors. Can CAR-NK cells equipped with an antigen specific receptor kill cancer cells as effectively as CAR-T cells? Hard to say.8 G9 Z4 C+ I% S6 T1 L% d' ~4 O

# P% p& @2 A5 }3 oPreclinical studies in leukemia, lymphoma, and multiple myeloma have been reported. For instance, treatment with anti-CS1 CAR-NK cells prolonged the survival of multiple myeloma mice from 40 days to 50 days[2].
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Sorrento intends to develop anti-CD19, anti-PDL1, anti-PSMA, and anti-CD123 CAR-NK cells. It is expected to initiate Phase I trials in 2016.6 ]5 j. Q8 U5 d# h
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[1] Oncoimmunology. 2014, 3, e28147. doi: 10.4161/onci.28147.
- d8 Q& j# f3 i5 h2 h% x# s5 P[2] Leukemia. 2014, 28(4), 917-927. / t. p, W) r& H' ]4 L

4 l) A  g- U& G' K. ]Related Articles:
! U) ]" O4 h/ x+ G8 DWhat are the next generation T cell immunotherapies
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沙发
发表于 2015-11-12 09:32 |只看该作者
回复 cantonchn 的帖子- V/ e4 w# `5 ~! @  t# L3 H

+ v* M  t$ |' e9 @3 W" \% q有中文的么?  英文的看起来有点难啊  

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藤椅
发表于 2015-11-12 21:10 |只看该作者
本帖最后由 cneagle66 于 2015-11-12 21:15 编辑
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2014年12月15日,Patrick Soon Shiong,世界上最富的医生,获得了Sorrento Therapeutic公司19.9%的股票,每股价格5.80美元,4天后,Sorrento and Conkwest 宣布共同开发CAR-NK免疫疗法,Sorrento的股票价格在2015年1月15上涨到每股11.38美元。
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CAR-T细胞免疫疗法被认为是近年来肿瘤治疗的突破性进展,很多开发CAR-T的公司(如JUNO, KITE, BLCM, BLUE, ZIOP)现在热的发红,Sorrento/Conkwest 正在研发表达CAR的NK细胞,而不是T细胞,CAR-NK和CAR-T相比如何?0 q' z. K  R) i' s5 T1 d

1 {; R$ {$ N& c8 O( V: j* q, f在OncoImmunology上有这样的比较,Hans Klingeman是NK-92细胞系的发明者,和他人在2002年共建了ZelleRx,即2010年更名为Conkwest的公司。CAR-NK具有很多优势:9 S4 ~* m6 I5 L3 q1 ^- f% ?

& A6 H( t  U* _(1)CAR-NK不产生IL-6,后者是细胞因子释放综合征的元凶,CAR-T治疗的临床试验所造成的多起患者死亡,都和IL-6升高有关。8 v; l0 @% r+ o1 `
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(2) CAR-NK 由于寿命较短,在外周循环中消除较快,不必担心持久的CAR相关的副反应。相应地 JUNO Therapeutics已经着手,插入EGFRt基因以控制CAR-T细胞的效应。, Q& W4 c2 I+ g# t& w% p

9 L% D* G* L( R0 j9 s3 F(3)NK细胞是连环杀手,可以聪明地从一个目标移动到另一目标,杀灭7-10个细胞。
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$ G- j; B# V2 R2 d; D5 M(4)NK-92细胞的转染效率达50%,甚至是非病毒载体也可轻易转染。不用病毒载体,就避免了癌基因的激活,插入突变等风险。
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(5)CAR-NK也可在GMP状态下批量生产,并可用于异体。
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# d) o0 p' W6 S- p通常,血循环中只有10%的NK,NK的活化依赖于抑制和活化受体刺激信号之间的平衡,正常细胞中的MHC I类分子抑制NK的活化。* Y6 u6 p( ^" `! ^. ]3 m- y5 }+ R

+ r, a# G! u3 v8 s) s& X" F7 K1 x- j天然的NK细胞不表达抗原特异性受体,装备了抗原特异性受体的CAR-NK是不是也和CAR-T一样有效的杀伤癌细胞,还很难说。( E+ r( s- T/ F9 L% n

  v4 N6 v1 F: l已经有了临床前的白血病、淋巴瘤、多发性骨髓瘤的报道,如用抗-CS1的CAR-NK治疗,可以延缓多发性骨髓瘤小鼠生存期,从40天延长到50天。/ \' Z# ?) p3 O6 Y
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Sorrento公司计划开发抗CD19、PD-L1、PMSA、CD123的CAR-NK,预计2016年开始临床I期试验。
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板凳
发表于 2015-11-19 18:27 |只看该作者
学习啦

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报纸
发表于 2015-11-20 13:46 |只看该作者
回复 cneagle66 的帖子
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' j5 `- d4 N% a6 v5 ?外周血中的NK数量应该没有10%这么多,正常在4%~6%之间。
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地板
发表于 2020-2-3 12:49 |只看该作者
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, Z- q! Y% ~1 R+ C$ l也是需要纯化的
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