1区 · 医学
Article
作者: Anagnostopoulos, Achilles ; Stergiouda, Zoi ; Bitzani, Militsa ; Vogiatzoglou, Anastasios ; Morfesis, Petros ; Theodorakopoulou, Maria ; Chatzika, Georgia ; Fylaktou, Asimina ; Stefanou, Garyfallia ; Bousiou, Zoi ; Karaglani, Antonia ; Papadimitriou, Vasiliki ; Giannaki, Maria ; Giannaki, Chrysavgi ; Siotou, Eleni ; Vallianou, Ioanna ; Stavridou, Fani ; Xochelli, Aliki ; Papalexandri, Apostolia ; Pitsiou, Georgia ; Sileli, Maria ; Karampatakis, Theodoros ; Varsamoudi, Evangelia ; Karavalakis, George ; Serasli, Eva ; Papadopoulou, Anastasia ; Papadopoulou, Efthymia ; Yannaki, Evangelia ; Doumas, Michalis ; Kammenou, Maria ; Georgakopoulou, Aphrodite ; Georgolopoulos, Grigorios ; Kapravelos, Nikolaos ; Kourlaba, Georgia ; Sakellari, Ioanna ; Gounelas, George ; Boukla, Anna ; Papayanni, Penelope-Georgia ; Triantafyllidou, Maria ; Zotou, Eleni ; Koutra, Maria-Georgia ; Apostolou, Dimitra ; Tryfon, Stavros
Despite advances, few therapeutics have shown efficacy in severe coronavirus disease 2019 (COVID-19). In a different context, virus-specific T cells have proven safe and effective. We conducted a randomized (2:1), open-label, phase 1/2 trial to evaluate the safety and efficacy of off-the-shelf, partially human leukocyte antigen (HLA)-matched, convalescent donor-derived severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific T cells (CoV-2-STs) in combination with standard of care (SoC) in patients with severe COVID-19 compared to SoC during Delta variant predominance. After a dose-escalated phase 1 safety study, 90 participants were randomized to receive CoV-2-ST+SoC (n = 60) or SoC only (n = 30). The co-primary objectives of the study were the composite of time to recovery and 30-d recovery rate and the in vivo expansion of CoV-2-STs in patients receiving CoV-2-ST+SoC over SoC. The key secondary objective was survival on day 60. CoV-2-ST+SoC treatment was safe and well tolerated. The study met the primary composite endpoint (CoV-2-ST+SoC versus SoC: recovery rate 65% versus 38%, P = 0.017; median recovery time 11 d versus not reached, P = 0.052, respectively; rate ratio for recovery 1.71 (95% confidence interval 1.03-2.83, P = 0.036)) and the co-primary objective of significant CoV-2-ST expansion compared to SοC (CoV-2-ST+SoC versus SoC, P = 0.047). Overall, in hospitalized patients with severe COVID-19, adoptive immunotherapy with CoV-2-STs was feasible and safe. Larger trials are needed to strengthen the preliminary evidence of clinical benefit in severe COVID-19. EudraCT identifier: 2021-001022-22 .