Nature Medicine：自体多抗原靶向的T细胞疗法治疗胰腺癌

Core Viewpoint - The article discusses the challenges and advancements in immunotherapy for pancreatic ductal adenocarcinoma (PDAC), highlighting a recent phase 1/2 clinical trial that demonstrates the safety and feasibility of autologous multiantigen-targeted T cell therapy for PDAC patients [2][3]. Summary by Sections Immunotherapy Challenges - PDAC presents significant challenges for effective immunotherapy due to weak expression of target antigens and frequent upregulation of immunosuppressive molecules, leading to a "cold tumor" microenvironment [2]. - The heterogeneity of tumor antigen expression can result in rapid adaptation and modulation of target antigens, hindering the potential of T cell monotherapy [2]. Clinical Trial Overview - A phase 1/2 clinical trial named TACTOPS was conducted to evaluate the safety and feasibility of an autologous non-engineered T cell product administered monthly at a dose of 1×10^7 cells/m² [7]. - The trial included three arms: patients responsive to first-line chemotherapy (Group A, n=13), patients resistant to first-line chemotherapy (Group B, n=12), and patients with resectable disease (Group C, n=12) [7]. Trial Results - Among 56 participants, 37 received the infusion with only one treatment-related serious adverse event reported [8]. - Disease control rates were 84.6% for Group A and 25% for Group B, while 2 out of 9 patients in Group C remained disease-free after 66 months of follow-up [8]. - The infused cells persisted for 12 months post-treatment, with responders showing higher levels of tumor-directed T cells compared to non-responders [8]. Conclusion and Future Directions - The study confirms the feasibility of generating autologous multi-tumor-associated antigen (mTAA) T cells for patients at all stages of pancreatic cancer, with a maximum of six infusions at a dose of 1×10^7 cells/m² being safe [8]. - The clinical outcomes are associated with the peripheral expansion of mTAA-targeted T cell clones and the emergence of antigen spreading during treatment, suggesting further research into TAA T cells as a standalone therapy or in combination with other novel immunotherapies or standard treatments [8].