PO.CL05.01 · 临床研究

KSQ-001EX(一种SOCS1编辑的eTIL®治疗)的抗肿瘤功能和长期持久性,独立于IL-2共同给药

Anti-tumor function and long-term persistence of KSQ-001EX, a SOCS1-edited eTIL® therapy, independent of IL-2 co-administration

海报缩略图:KSQ-001EX(一种SOCS1编辑的eTIL®治疗)的抗肿瘤功能和长期持久性,独立于IL-2共同给药
编号 3721 展板 23 时间 4/20 02:00–05:00 区域 Section 40 主讲 Dipen Sangurdekar, MBA;PhD
分会场 Adoptive Cell Therapy 1
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作者与单位 Authors & Affiliations

Dipen Sangurdekar1, Erica Tobin1, Karrie Wong1, Ashish Yeri1, Alex Smashnov1, Kelly Bowen1, Giorgio Sarkis1, Violetta Medik1, Hsinyi Lu2, Sevinj Isgandarova2, Michelle Carrasco1, Patricia Harris1, Cara L. Haymaker2, Micah Benson1, Anna Truppel-Hartmann1, Rodabe N. Amaria2

1KSQ Therapeutics, Lexington, MA,2UT MD Anderson Cancer Center, Houston, TX

摘要 Abstract

中文摘要
肿瘤浸润淋巴细胞(TIL)治疗是一种针对癌症的自体过继细胞治疗,涉及从患者自身肿瘤中分离、体外扩增并回输多克隆T细胞。为提高TIL治疗的临床疗效和持久性,我们开发了KSQ-001EX,一种CRISPR/Cas9工程化的TIL(eTIL®)治疗,通过失活SOCS1基因以增强T细胞持久性和抗肿瘤功能。KSQ-001EX正在一项针对晚期实体瘤患者的1/2期临床研究(NCT06237881)中接受考察。转移性黑色素瘤患者接受清淋巴化疗,随后在队列1(n=4)中接受不含IL-2的KSQ-001EX,或在队列2(n=8)中接受含高剂量IL-2的KSQ-001EX,剂量范围为0.5-10e9个细胞(中位数5.25e9)。通过对SOCS1基因位点的插入缺失(indel)追踪,在血液和组织样本中直接监测KSQ-001EX。通过整合患者基线特征、药品(DP)生产数据、肿瘤起始材料的多模态和单细胞表征、KSQ-001EX DP、输注后PBMC以及治疗中肿瘤组织活检,进行相关性分析。全部12份KSQ-001EX DP均富集CD8+ T细胞,表现出“Young TIL”表型,CD27+细胞中位数为39%,且耗竭标志物表达低。所有DP对重定向裂解靶细胞系均表现出强大的多功能性和细胞毒性。输注细胞剂量,尤其是CD27+ KSQ-001EX细胞的绝对剂量,可预测第28天KSQ-001EX在肿瘤组织中的输注后植入、扩增、持久性和浸润,并且是与临床活性相关的最强因素。对输注后血液中T细胞的克隆追踪显示,在大多数患者中以及各队列之间,KSQ-001EX克隆在第9天前和第21天后有相似的扩增,肿瘤中的顶级浸润克隆与第28天血液中的克隆扩增相关。为进一步了解IL-2对KSQ-001EX植入、持久性和功能的贡献,比较了队列1和队列2输注后外周血CD8+ T细胞的细胞因子和表型特征。虽然各队列之间CD8+ T细胞的频率或活化状态未观察到差异,但在队列2(含IL-2)中,输注后第9-28天观察到CD8+ T细胞中TOX表达升高以及Treg频率增加。总之,输注更高的CD27+ KSQ-001EX剂量与有利的扩增动力学和持久性相关。KSQ-001EX在无IL-2且剂量低于传统未修饰TIL常用剂量的情况下实现植入、发挥功能并长期持久,提示SOCS1失活的有益作用。基于这些综合数据,我们确认了SOCS1缺失所带来的功能增强。有必要进一步在无IL-2和更高DP剂量条件下研究eTIL。
查看英文原文 English abstract
Tumor Infiltrating Lymphocyte (TIL) therapy is an autologous adoptive cell therapy for cancer involving the isolation, ex vivo expansion, and infusion of polyclonal T cells from a patient's own tumor. Seeking to improve clinical efficacy and durability of TIL therapy, we developed KSQ-001EX, a CRISPR/Cas9 engineered TIL (eTIL ® ) therapy with inactivation of the SOCS1 gene to enhance T cell persistence and anti-tumor functionality. KSQ-001EX is being investigated in a phase 1/2 clinical study (NCT06237881) in patients with advanced solid tumors. Metastatic melanoma patients received lymphodepleting chemotherapy followed by KSQ-001EX without IL-2 in Cohort 1 (n=4) or with high-dose IL-2 in Cohort 2 (n=8), at a dose range of 0.5-10e9 cells (median 5.25e9). KSQ-001EX was directly monitored in blood and tissue samples via indel tracking of the SOCS1 gene locus. Correlative analyses were performed by integrating patient baseline characteristics, drug product (DP) manufacturing data, multi-modal and single-cell characterization of tumor starting material, KSQ-001EX DP, post-infusion PBMCs and on-treatment tumor tissue biopsies. All 12 KSQ-001EX DPs were enriched in CD8+ T cells, exhibiting a “Young TIL” phenotype with a median of 39% CD27+ cells and low expression of exhaustion markers. All DPs showed strong polyfunctionality and cytotoxicity against redirected lysis targetcell lines. Infused cell dose, particularly absolute dose of CD27+ KSQ-001EX cells, predicted post-infusion engraftment, expansion, persistence, and infiltration of KSQ-001EX in tumor tissue at day 28, and was the strongest factor associated with clinical activity. Clonal tracking of T cells in post-infusion blood revealed similar expansion of KSQ-001EX clones before day 9 and after day 21 across most patients and between cohorts, with top infiltrating clones in tumor correlating with clonal expansion in blood at day 28. To further understand the contribution of IL-2 to KSQ-001EX engraftment, persistence and function, cytokines and phenotypic characteristics of peripheral blood CD8+ T cells post-infusion were compared between Cohort 1 and Cohort 2. While no differences were observed in the frequency or activation state of CD8+ T cells between Cohorts, elevated expression of TOX in CD8+ T cells and increased frequencies of Treg were observed in Cohort 2 (with IL-2) between day 9-28 post infusion. In conclusion, higher infused CD27+ KSQ-001EX dose is associated with favorable expansion kinetics and persistence. KSQ-001EX engraftment, function and long-term persistence in absence of IL-2 at lower doses than traditionally used with unmodified TIL suggest the beneficial effects of SOCS1 inactivation. Based on these collective data, we confirm the functional enhancement introduced by SOCS1 deletion. Further investigation of eTIL in the absence of IL-2 and higher DP doses is warranted.
利益披露 Disclosure
D. Sangurdekar, KSQ Therapeutics Employment, Stock Option. E. Tobin, KSQ Therapeutics Employment. K. Wong, KSQ Therapeutics Employment. A. Yeri, KSQ Therapeutics Employment. A. Smashnov, KSQ Therapeutics Employment. K. Bowen, KSQ Therapeutics Employment. G. Sarkis, KSQ Therapeutics Employment. V. Medik, KSQ Therapeutics Employment. H. Lu, None.. S. Isgandarova, None. M. Carrasco, KSQ Therapeutics Employment. P. Harris, KSQ Therapeutics Employment. M. Benson, KSQ Therapeutics Employment. A. Truppel-Hartmann, KSQ Therapeutics Employment. R. N. Amaria, None.

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