Phase I Escalating-Dose Trial of CAR-T Therapy Targeting CEA+ Metastatic Colorectal Cancers

针对CEA阳性转移性结直肠癌的CAR-T疗法I期剂量递增试验

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作者:Chengcheng Zhang,Zhe Wang,Zhi Yang,Meiling Wang,Shiqi Li,Yunyan Li,Rui Zhang,Zhouxing Xiong,Zhihao Wei,Junjie Shen,Yongli Luo,Qianzhen Zhang,Limei Liu,Hong Qin,Wei Liu,Feng Wu,Wei Chen,Feng Pan,Xianquan Zhang,Ping Bie,Houjie Liang,Gabriele Pecher,Cheng Qian

Abstract

Chimeric antigen receptor T (CAR-T) cells have shown promising efficacy in treatment of hematological malignancies, but its applications in solid tumors need further exploration. In this study, we investigated CAR-T therapy targeting carcino-embryonic antigen (CEA)-positive colorectal cancer (CRC) patients with metastases to evaluate its safety and efficacy. Five escalating dose levels (DLs) (1 × 105 to 1 × 108/CAR+/kg cells) of CAR-T were applied in 10 CRC patients. Our data showed that severe adverse events related to CAR-T therapy were not observed. Of the 10 patients, 7 patients who experienced progressive disease (PD) in previous treatments had stable disease after CAR-T therapy. Two patients remained with stable disease for more than 30 weeks, and two patients showed tumor shrinkage by positron emission tomography (PET)/computed tomography (CT) and MRI analysis, respectively. Decline of serum CEA level was apparent in most patients even in long-term observation. Furthermore, we observed persistence of CAR-T cells in peripheral blood of patients receiving high doses of CAR-T therapy. Importantly, we observed CAR-T cell proliferation especially in patients after a second CAR-T therapy. Taken together, we demonstrated that CEA CAR-T cell therapy was well tolerated in CEA+ CRC patients even in high doses, and some efficacy was observed in most of the treated patients.

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