2021 CSCO Professor Qing Xu: A new model for the treatment of malignant mesothelioma-αPD-1-mesoCAR-T cell therapy

Introduction Malignant mesothelioma is a rare and highly aggressive malignant tumor that originates in mesothelial cells.
There are approximately 3,000 confirmed cases in China each year, mainly pleural mesothelioma
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The prognosis of malignant pleural mesothelioma is generally poor.
The median survival time of patients with untreated advanced or metastatic malignant pleural mesothelioma is less than 1 year, and the 5-year survival rate is less than 10%
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During the 2021 CSCO meeting, Yimaitong had the honor to interview Professor Xu Qing from Shanghai Tenth People's Hospital affiliated to Tongji University to share with us the research progress of immunotherapy in malignant mesothelioma
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Expert Profile Professor Xu Qing Chief Physician, Professor, Doctoral Supervisor Director of Oncology Department, Shanghai Tenth People's Hospital Affiliated to Tongji University Chairman of the Pelvic Tumor Professional Committee of the Education Association Shanghai Anti-Cancer Association Tumor Immunotherapy Professional Committee Designate Director Specialized areas: tumor immunotherapy, targeted therapy, chemotherapy, palliative and palliative treatment; digestive system tumors, skin malignancies, pelvic malignancies Tumor, lung cancer and other solid malignant tumor articles published: the first and corresponding author published more than 60 SCI articles in magazines such as Oncogene and DNA&Cell biology; edited two monographs and participated in the compilation of the eight-year textbook compiled by the Ministry of Health.
The first edition of "Oncology" and many other books won awards: won the Chinese Medical Association, the Ministry of Education, the Shanghai Medical Association, the Shanghai Science and Technology Commission, the People's Liberation Army and other medical science and technology awards.
mesoCAR-T cell therapy Professor Qing Xu: At present, immunotherapy represented by PD-1 antibody is in the center of tumor treatment, but there are still some tumors, including malignant pleural stromal tumors, with relatively low benefit rates.
In this case, we began to actively explore new treatment models
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At this CSCO meeting, we reported the phase I clinical safety and efficacy observation results of autocrine PD-1 nanobody-based MSLN-CAR-T cells (apD-1-mesoCAR-T) in the treatment of malignant mesothelioma
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aPD-1-mesoCAR-T cell therapy, which combines immune checkpoint inhibitors and CAR-T cells, can play a synergistic effect of dual anti-tumor immune mechanisms
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In the future, it is possible to achieve a breakthrough in malignant pleural stromal tumors that are generally recognized as poorly effective or refractory malignant tumors that are not sensitive to immunotherapy
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At the same time, based on a new target such as mesothelin, it is hoped that PD-1 combined with CAR-T antibody can make a breakthrough in refractory malignant tumors including advanced ovarian cancer
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αPD-1-mesoCAR-T brings benefits to patients with malignant mesothelioma Professor Qing Xu: From the perspective of patient benefits, we must first consider the effectiveness of αPD-1-mesoCAR-T therapy
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The main purpose of any clinical research is to improve the survival period and quality of life of patients
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In the preliminary study results, we have observed that some patients have achieved partial remission (PR) and complete remission.
We hope that more patients will benefit in the follow-up phase II clinical study results
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In addition, we also hope that these patients can receive comprehensive treatment at the same stage
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Facts have also proved that the CAR-T cell combination therapy that secretes PD-1 antibodies has the dual effects of immune checkpoint inhibitors and CAR-T, and has improved practicability and effectiveness
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 The dilemma and hope of CAR-T cell therapy in solid tumors Professor Xu Qing: At present, CAR-T cell therapy has made remarkable achievements in the treatment of hematological tumors, especially acute lymphoblastic leukemia and lymphoma.
Provides ideas for CAR-T cell treatment of solid tumors
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At present, the application of CAR-T therapy is limited due to the complexity of solid tumors and the lack of good antigen targets
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Finding effective targets and screening high-risk patients through new technologies (including circulating tumor cell detection, single-cell sequencing technology, circulating tumor DNA detection, etc.
) may be the direction of exploration of cell curative effects including CAR-T in solid tumors
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Of course, we still need to carry out more clinical research verification
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