CAR-T細胞の「攻撃力」を予測~CAR-T製造中の細胞増殖が治療効果と相関する~

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2025-07-25 京都大学

京都大学の研究グループは、CD19標的CAR-T細胞療法を受けたB細胞リンパ腫75症例を対象に、治療効果とCAR-T細胞製造中のT細胞増殖の関係を検討。その結果、細胞増殖が良好だった症例は治療効果も高いことが判明し、CAR-T細胞の抗腫瘍「攻撃力」を製造段階で予測できる可能性が示された。これにより、CAR-T療法の個別化や治療戦略の最適化が期待される。本成果は英誌「British Journal of Haematology」に掲載された。

CAR-T細胞の「攻撃力」を予測~CAR-T製造中の細胞増殖が治療効果と相関する~

<関連情報>

製造中のex vivo細胞増殖の一貫性が、CAR-T細胞療法後の良好な転帰を予測する Consistent ex vivo cell proliferation during manufacturing predicts favourable outcomes post-CAR-T-cell therapy

Tomoyasu Jo, Yasuyuki Arai, Tomoshige Shimizu, Toshio Kitawaki, Takashi Sakamoto, Chisaki Mizumoto, Junya Kanda, Momoko Nishikori, Kohei Yamashita, Miki Nagao, Akifumi Takaori-Kondo
British Journal of Haematology  Published: 09 July 2025
DOI:https://doi.org/10.1111/bjh.20266

Summary

Efficacy of chimeric antigen receptor (CAR) T-cell therapy hinges on CAR-T potency, as well as on tumour traits and disease status. Potency assessment currently relies on post-infusion in vivo growth; therefore, manufacturing metrics could provide early potency predictions, enabling potency-guided strategies. To assess the impact of ex vivo cell growth during manufacturing on clinical outcomes, we analysed diffuse large B-cell lymphoma patients treated with tisagenlecleucel, merging clinical records with manufacturing parameters. Of 75 cases, 21 (28%) showed poor growth, indicated by any decrease in cell number during manufacturing. Good growth correlated with significantly better overall response rate (85.2% vs. 52.4%; p = 0.006), with enhanced lymphocyte increase in peripheral blood after infusion. Multivariate analysis revealed that this group had significantly higher progression-free survival (PFS) (adjusted hazard ratio [aHR]: 0.377; 95% confidence interval [CI]: 0.180–0.789; p = 0.010) and overall survival (OS) (aHR: 0.191; 95% CI: 0.071–0.510; p = 0.001), with lower cumulative incidence of disease progression (aHR: 0.412; 95% CI: 0.198–0.858; p = 0.018), compared to the poor growth group, even after adjusting for clinical factors, bridging therapies performed between apheresis and infusion and disease status at infusion. Our findings suggest that good cell growth during manufacturing predicts favourable post-CAR-T outcomes. Identifying clinical factors that influence manufacturing parameters could improve post-CAR-T outcomes.

医療・健康
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