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Safety and feasibility of CRISPR-edited T cells in patients with refractory non-small-cell lung cancer.

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机构: [1]Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China. [2]Chengdu MedGenCell, Co., Ltd, Chengdu, China. [3]Jacobi Medical Center, NYC Health Hospitals, Albert Einstein College of Medicine, New York, NY, USA. [4]Geneplus-Beijing Institute, Beijing, China. [5]Center of GCP, West China Hospital, Sichuan University, Chengdu, China. [6]ZenRhyme Consulting Service, Ltd, Shanghai, China. [7]National Research Center for Translational Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. [8]Berry Oncology Co. Ltd, Fujian, China. [9]Department of Pathology, West China Hospital, Sichuan University, Chengdu, China. [10]Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China. [11]State Key Laboratory of Biotherapy and Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, China. [12]Department of Respiratory and Critical Care Medicine and Frontier Science Center of Disease Molecular Network, West China Hospital, Sichuan University, Chengdu, China. [13]State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Chinese University of Hong Kong, Hong Kong, China.
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Clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 editing of immune checkpoint genes could improve the efficacy of T cell therapy, but the first necessary undertaking is to understand the safety and feasibility. Here, we report results from a first-in-human phase I clinical trial of CRISPR-Cas9 PD-1-edited T cells in patients with advanced non-small-cell lung cancer (ClinicalTrials.gov NCT02793856). Primary endpoints were safety and feasibility, and the secondary endpoint was efficacy. The exploratory objectives included tracking of edited T cells. All prespecified endpoints were met. PD-1-edited T cells were manufactured ex vivo by cotransfection using electroporation of Cas9 and single guide RNA plasmids. A total of 22 patients were enrolled; 17 had sufficient edited T cells for infusion, and 12 were able to receive treatment. All treatment-related adverse events were grade 1/2. Edited T cells were detectable in peripheral blood after infusion. The median progression-free survival was 7.7 weeks (95% confidence interval, 6.9 to 8.5 weeks) and median overall survival was 42.6 weeks (95% confidence interval, 10.3-74.9 weeks). The median mutation frequency of off-target events was 0.05% (range, 0-0.25%) at 18 candidate sites by next generation sequencing. We conclude that clinical application of CRISPR-Cas9 gene-edited T cells is generally safe and feasible. Future trials should use superior gene editing approaches to improve therapeutic efficacy.

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出版当年[2020]版:
大类 | 1 区 医学
小类 | 1 区 生化与分子生物学 1 区 细胞生物学 1 区 医学:研究与实验
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 生化与分子生物学 1 区 细胞生物学 1 区 医学:研究与实验
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第一作者机构: [1]Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
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