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Pandit S, Agarwalla P, Song F, Jansson A, Dotti G, Brudno Y. Implantable CAR T cell factories enhance solid tumor treatment. Biomaterials 2024; 308:122580. [PMID: 38640784 PMCID: PMC11125516 DOI: 10.1016/j.biomaterials.2024.122580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/11/2024] [Accepted: 04/13/2024] [Indexed: 04/21/2024]
Abstract
Chimeric Antigen Receptor (CAR) T cell therapy has produced revolutionary success in hematological cancers such as leukemia and lymphoma. Nonetheless, its translation to solid tumors faces challenges due to manufacturing complexities, short-lived in vivo persistence, and transient therapeutic impact. We introduce 'Drydux' - an innovative macroporous biomaterial scaffold designed for rapid, efficient in-situ generation of tumor-specific CAR T cells. Drydux expedites CAR T cell preparation with a mere three-day turnaround from patient blood collection, presenting a cost-effective, streamlined alternative to conventional methodologies. Notably, Drydux-enabled CAR T cells provide prolonged in vivo release, functionality, and enhanced persistence exceeding 150 days, with cells transitioning to memory phenotypes. Unlike conventional CAR T cell therapy, which offered only temporary tumor control, equivalent Drydux cell doses induced lasting tumor remission in various animal tumor models, including systemic lymphoma, peritoneal ovarian cancer, metastatic lung cancer, and orthotopic pancreatic cancer. Drydux's approach holds promise in revolutionizing solid tumor CAR T cell therapy by delivering durable, rapid, and cost-effective treatments and broadening patient accessibility to this groundbreaking therapy.
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Affiliation(s)
- Sharda Pandit
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, NC, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
| | - Pritha Agarwalla
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, NC, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
| | - Feifei Song
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anton Jansson
- Department of Product Development, Production and Design, School of Engineering, Jönköping University, Sweden
| | - Gianpietro Dotti
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yevgeny Brudno
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, NC, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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2
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Dias J, Garcia J, Agliardi G, Roddie C. CAR-T cell manufacturing landscape-Lessons from the past decade and considerations for early clinical development. Mol Ther Methods Clin Dev 2024; 32:101250. [PMID: 38737799 PMCID: PMC11088187 DOI: 10.1016/j.omtm.2024.101250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
CAR-T cell therapies have consolidated their position over the last decade as an effective alternative to conventional chemotherapies for the treatment of a number of hematological malignancies. With an exponential increase in the number of commercial therapies and hundreds of phase 1 trials exploring CAR-T cell efficacy in different settings (including autoimmunity and solid tumors), demand for manufacturing capabilities in recent years has considerably increased. In this review, we explore the current landscape of CAR-T cell manufacturing and discuss some of the challenges limiting production capacity worldwide. We describe the latest technical developments in GMP production platform design to facilitate the delivery of a range of increasingly complex CAR-T cell products, and the challenges associated with translation of new scientific developments into clinical products for patients. We explore all aspects of the manufacturing process, namely early development, manufacturing technology, quality control, and the requirements for industrial scaling. Finally, we discuss the challenges faced as a small academic team, responsible for the delivery of a high number of innovative products to patients. We describe our experience in the setup of an effective bench-to-clinic pipeline, with a streamlined workflow, for implementation of a diverse portfolio of phase 1 trials.
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Affiliation(s)
- Juliana Dias
- Centre for Cell, Gene and Tissue Therapeutics, Royal Free Hospital NHS Foundation Trust, London NW3 2QG, UK
- Research Department of Haematology, Cancer Institute, University College London, London WC1E 6DD, UK
| | - John Garcia
- Centre for Cell, Gene and Tissue Therapeutics, Royal Free Hospital NHS Foundation Trust, London NW3 2QG, UK
- Research Department of Haematology, Cancer Institute, University College London, London WC1E 6DD, UK
| | - Giulia Agliardi
- Centre for Cell, Gene and Tissue Therapeutics, Royal Free Hospital NHS Foundation Trust, London NW3 2QG, UK
- Research Department of Haematology, Cancer Institute, University College London, London WC1E 6DD, UK
| | - Claire Roddie
- Research Department of Haematology, Cancer Institute, University College London, London WC1E 6DD, UK
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3
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Malakhova E, Pershin D, Kulakovskaya E, Vedmedskaia V, Fadeeva M, Lodoeva O, Sozonova T, Muzalevskii Y, Kazachenok A, Belchikov V, Shelikhova L, Molostova O, Volkov D, Maschan M. Extended characterization of anti-CD19 CAR T cell products manufactured at the point of care using the CliniMACS Prodigy system: comparison of donor sources and process duration. Cytotherapy 2024; 26:567-578. [PMID: 38493403 DOI: 10.1016/j.jcyt.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND AIMS The CliniMACS Prodigy closed system is widely used for the manufacturing of chimeric antigen receptor T cells (CAR-T cells). Our study presents an extensive immunophenotypic and functional characterization and comparison of the properties of anti-CD19 CAR-T cell products obtained during long (11 days) and short (7 days) manufacturing cycles using the CliniMACS Prodigy system, as well as cell products manufactured from different donor sources of T lymphocytes: from patients, from patients who underwent HSCT, and from haploidentical donors. We also present the possibility of assessing the efficiency of transduction by an indirect method. METHODS Seventy-six CD19 CAR-T cell products were manufactured using the CliniMACS Prodigy automated system. Immunophenotypic properties, markers of cell activation and exhaustion, antitumor, anti-CD19 specific activity in vitro of the manufactured cell products were evaluated. As an indirect method for assessing the efficiency of transduction, we used the method of functional assessment of cytokine secretion and expression of the CD107a marker after incubation of CAR-T cells with tumor targets. RESULTS The CliniMACS Prodigy platform can produce a product of CD19 CAR-T cells with sufficient cell expansion (4.6 × 109 cells-median for long process [LP] and 1.6 × 109-for short process [SP]), transduction efficiency (43.5%-median for LP and 41.0%-for SP), represented mainly by T central memory cell population, with low expression of exhaustion markers, and with high specific antitumor activity in vitro. We did not find significant differences in the properties of the products obtained during the 7- and 11-day manufacturing cycles, which is in favor of reducing the duration of production to 7 days, which may accelerate CAR-T therapy. We have shown that donor sources for CAR-T manufacturing do not significantly affect the composition and functional properties of the cell product. CONCLUSIONS This study demonstrates the possibility of using the CliniMACS Prodigy system with a shortened 7-day production cycle to produce sufficient amount of functional CAR-T cells. CAR transduction efficiency can be measured indirectly via functional assays.
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Affiliation(s)
- Ekaterina Malakhova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia.
| | - Dmitriy Pershin
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Elena Kulakovskaya
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Viktoria Vedmedskaia
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Mariia Fadeeva
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Oyuna Lodoeva
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Tatiana Sozonova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Yakov Muzalevskii
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Alexei Kazachenok
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Vladislav Belchikov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Larisa Shelikhova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Olga Molostova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Dmitry Volkov
- M.M. Shemyakin and Yu.A. Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences, Moscow, Russia
| | - Michael Maschan
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
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4
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Lin HK, Uricoli B, Freeman RM, Hossian AKMN, He Z, Anderson JYL, Neffling M, Legier JM, Blake DA, Doxie DB, Nair R, Koff JL, Dhodapkar KM, Shanmugam M, Dreaden EC, Rafiq S. Engineering Improved CAR T Cell Products with A Multi-Cytokine Particle Platform for Hematologic and Solid Tumors. Adv Healthc Mater 2024; 13:e2302425. [PMID: 38245855 PMCID: PMC11144092 DOI: 10.1002/adhm.202302425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/05/2024] [Indexed: 01/22/2024]
Abstract
Despite the remarkable clinical efficacy of chimeric antigen receptor (CAR) T cells in hematological malignancies, only a subset of patients achieves a durable complete response (dCR). DCR has been correlated with CAR T cell products enriched with T cells memory phenotypes. Therefore, reagents that consistently promote memory phenotypes during the manufacturing of CAR T cells have the potential to significantly improve clinical outcomes. A novel modular multi-cytokine particle (MCP) platform is developed that combines the signals necessary for activation, costimulation, and cytokine support into a single "all-in-one" stimulation reagent for CAR T cell manufacturing. This platform allows for the assembly and screening of compositionally diverse MCP libraries to identify formulations tailored to promote specific phenotypes with a high degree of flexibility. The approach is leveraged to identify unique MCP formulations that manufacture CAR T cell products from diffuse large B cell patients with increased proportions of memory-like phenotypes MCP-manufactured CAR T cells demonstrate superior anti-tumor efficacy in mouse models of lymphoma and ovarian cancer through enhanced persistence. These findings serve as a proof-of-principle of the powerful utility of the MCP platform to identify "all-in-one" stimulation reagents that can improve the effectiveness of cell therapy products through optimal manufacturing.
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Affiliation(s)
- Heather K. Lin
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
| | - Biaggio Uricoli
- Wallace H. Coulter Department of Biomedical Engineering at Emory University and Georgia Institute of Technology Atlanta, GA, USA
| | - Ruby M. Freeman
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
| | - AKM Nawshad Hossian
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
| | - Zhulin He
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Jonathan M. Legier
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
| | - Dejah A. Blake
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
| | - Deon B. Doxie
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Remya Nair
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
| | - Jean L. Koff
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Kavita M. Dhodapkar
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - Mala Shanmugam
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Erik C. Dreaden
- Wallace H. Coulter Department of Biomedical Engineering at Emory University and Georgia Institute of Technology Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
| | - Sarwish Rafiq
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
- Winship Cancer Institute, Atlanta, GA, USA
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5
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Ingels J, De Cock L, Stevens D, Mayer RL, Théry F, Sanchez GS, Vermijlen D, Weening K, De Smet S, Lootens N, Brusseel M, Verstraete T, Buyle J, Van Houtte E, Devreker P, Heyns K, De Munter S, Van Lint S, Goetgeluk G, Bonte S, Billiet L, Pille M, Jansen H, Pascal E, Deseins L, Vantomme L, Verdonckt M, Roelandt R, Eekhout T, Vandamme N, Leclercq G, Taghon T, Kerre T, Vanommeslaeghe F, Dhondt A, Ferdinande L, Van Dorpe J, Desender L, De Ryck F, Vermassen F, Surmont V, Impens F, Menten B, Vermaelen K, Vandekerckhove B. Neoantigen-targeted dendritic cell vaccination in lung cancer patients induces long-lived T cells exhibiting the full differentiation spectrum. Cell Rep Med 2024; 5:101516. [PMID: 38626769 DOI: 10.1016/j.xcrm.2024.101516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/09/2024] [Accepted: 03/25/2024] [Indexed: 05/24/2024]
Abstract
Non-small cell lung cancer (NSCLC) is known for high relapse rates despite resection in early stages. Here, we present the results of a phase I clinical trial in which a dendritic cell (DC) vaccine targeting patient-individual neoantigens is evaluated in patients with resected NSCLC. Vaccine manufacturing is feasible in six of 10 enrolled patients. Toxicity is limited to grade 1-2 adverse events. Systemic T cell responses are observed in five out of six vaccinated patients, with T cell responses remaining detectable up to 19 months post vaccination. Single-cell analysis indicates that the responsive T cell population is polyclonal and exhibits the near-entire spectrum of T cell differentiation states, including a naive-like state, but excluding exhausted cell states. Three of six vaccinated patients experience disease recurrence during the follow-up period of 2 years. Collectively, these data support the feasibility, safety, and immunogenicity of this treatment in resected NSCLC.
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Affiliation(s)
- Joline Ingels
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium
| | - Laurenz De Cock
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; Department of Biomolecular Medicine, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Dieter Stevens
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; Respiratory Medicine, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Rupert L Mayer
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; Department of Biomolecular Medicine, Ghent University, 9000 Ghent, East-Flanders, Belgium; VIB-UGent Center for Medical Biotechnology, VIB, 9000 Ghent, East-Flanders, Belgium
| | - Fabien Théry
- Department of Biomolecular Medicine, Ghent University, 9000 Ghent, East-Flanders, Belgium; VIB-UGent Center for Medical Biotechnology, VIB, 9000 Ghent, East-Flanders, Belgium
| | - Guillem Sanchez Sanchez
- Department of Pharmacotherapy and Pharmaceutics, Université Libre de Bruxelles, 1050 Brussels, Brussels, Belgium; Institute for Medical Immunology, Université Libre de Bruxelles, 1050 Brussels, Brussels, Belgium; Université Libre de Bruxelles Center for Research in Immunology, Université Libre de Bruxelles, 1050 Brussels, Brussels, Belgium; WELBIO Department, WEL Research Institute, 1300 Wavre, Walloon Brabant, Belgium
| | - David Vermijlen
- Department of Pharmacotherapy and Pharmaceutics, Université Libre de Bruxelles, 1050 Brussels, Brussels, Belgium; Institute for Medical Immunology, Université Libre de Bruxelles, 1050 Brussels, Brussels, Belgium; Université Libre de Bruxelles Center for Research in Immunology, Université Libre de Bruxelles, 1050 Brussels, Brussels, Belgium; WELBIO Department, WEL Research Institute, 1300 Wavre, Walloon Brabant, Belgium
| | - Karin Weening
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Saskia De Smet
- GMP Unit Cell Therapy, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Nele Lootens
- GMP Unit Cell Therapy, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Marieke Brusseel
- GMP Unit Cell Therapy, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Tasja Verstraete
- Respiratory Medicine, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Jolien Buyle
- Respiratory Medicine, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Eva Van Houtte
- GMP Unit Cell Therapy, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Pam Devreker
- GMP Unit Cell Therapy, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Kelly Heyns
- GMP Unit Cell Therapy, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Stijn De Munter
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium
| | - Sandra Van Lint
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; Respiratory Medicine, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Glenn Goetgeluk
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Sarah Bonte
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; VIB-UGent Center for Medical Biotechnology, VIB, 9000 Ghent, East-Flanders, Belgium
| | - Lore Billiet
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium
| | - Melissa Pille
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Hanne Jansen
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Eva Pascal
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium
| | - Lucas Deseins
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium
| | - Lies Vantomme
- Department of Biomolecular Medicine, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Maarten Verdonckt
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Ria Roelandt
- VIB Single Cell Core, VIB, 9000/3000 Ghent/Leuven, East-Flanders/Flemish Brabant, Belgium
| | - Thomas Eekhout
- VIB Single Cell Core, VIB, 9000/3000 Ghent/Leuven, East-Flanders/Flemish Brabant, Belgium
| | - Niels Vandamme
- VIB Single Cell Core, VIB, 9000/3000 Ghent/Leuven, East-Flanders/Flemish Brabant, Belgium
| | - Georges Leclercq
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Tom Taghon
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Tessa Kerre
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; VIB-UGent Center for Medical Biotechnology, VIB, 9000 Ghent, East-Flanders, Belgium; Hematology, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Floris Vanommeslaeghe
- Nephrology, Ghent University Hospital, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Annemieke Dhondt
- Nephrology, Ghent University Hospital, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Liesbeth Ferdinande
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; Pathology, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Jo Van Dorpe
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; Pathology, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Liesbeth Desender
- Thoracic and Vascular Surgery, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Frederic De Ryck
- Thoracic and Vascular Surgery, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Frank Vermassen
- Thoracic and Vascular Surgery, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Veerle Surmont
- Respiratory Medicine, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium
| | - Francis Impens
- Department of Biomolecular Medicine, Ghent University, 9000 Ghent, East-Flanders, Belgium; VIB-UGent Center for Medical Biotechnology, VIB, 9000 Ghent, East-Flanders, Belgium
| | - Björn Menten
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; Department of Biomolecular Medicine, Ghent University, 9000 Ghent, East-Flanders, Belgium
| | - Karim Vermaelen
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; Respiratory Medicine, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium.
| | - Bart Vandekerckhove
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, East-Flanders, Belgium; Cancer Research Institute Ghent (CRIG), 9000 Ghent, Easy-Flanders, Belgium; GMP Unit Cell Therapy, Ghent University Hospital, 9000 Ghent, East-Flanders, Belgium.
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6
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Ramapriyan R, Vykunta VS, Vandecandelaere G, Richardson LGK, Sun J, Curry WT, Choi BD. Altered cancer metabolism and implications for next-generation CAR T-cell therapies. Pharmacol Ther 2024; 259:108667. [PMID: 38763321 DOI: 10.1016/j.pharmthera.2024.108667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/30/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
This review critically examines the evolving landscape of chimeric antigen receptor (CAR) T-cell therapy in treating solid tumors, with a particular focus on the metabolic challenges within the tumor microenvironment. CAR T-cell therapy has demonstrated remarkable success in hematologic malignancies, yet its efficacy in solid tumors remains limited. A significant barrier is the hostile milieu of the tumor microenvironment, which impairs CAR T-cell survival and function. This review delves into the metabolic adaptations of cancer cells and their impact on immune cells, highlighting the competition for nutrients and the accumulation of immunosuppressive metabolites. It also explores emerging strategies to enhance CAR T-cell metabolic fitness and persistence, including genetic engineering and metabolic reprogramming. An integrated approach, combining metabolic interventions with CAR T-cell therapy, has the potential to overcome these constraints and improve therapeutic outcomes in solid tumors.
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Affiliation(s)
- Rishab Ramapriyan
- Brain Tumor Immunotherapy Laboratory, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
| | - Vivasvan S Vykunta
- Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA; ImmunoX Initiative, University of California, San Francisco, San Francisco, CA 94143, USA; Medical Scientist Training Program, School of Medicine, University of California, San Francisco, San Francisco, CA 94143, USA; Biomedical Sciences Graduate Program, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Gust Vandecandelaere
- Brain Tumor Immunotherapy Laboratory, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Leland G K Richardson
- Brain Tumor Immunotherapy Laboratory, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Jing Sun
- Brain Tumor Immunotherapy Laboratory, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - William T Curry
- Brain Tumor Immunotherapy Laboratory, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Bryan D Choi
- Brain Tumor Immunotherapy Laboratory, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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7
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Dreyzin A, Rankin AW, Luciani K, Gavrilova T, Shah NN. Overcoming the challenges of primary resistance and relapse after CAR-T cell therapy. Expert Rev Clin Immunol 2024:1-19. [PMID: 38739466 DOI: 10.1080/1744666x.2024.2349738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/26/2024] [Indexed: 05/16/2024]
Abstract
INTRODUCTION While CAR T-cell therapy has led to remarkable responses in relapsed B-cell hematologic malignancies, only 50% of patients ultimately have a complete, sustained response. Understanding the mechanisms of resistance and relapse after CAR T-cell therapy is crucial to future development and improving outcomes. AREAS COVERED We review reasons for both primary resistance and relapse after CAR T-cell therapies. Reasons for primary failure include CAR T-cell manufacturing problems, suboptimal fitness of autologous T-cells themselves, and intrinsic features of the underlying cancer and tumor microenvironment. Relapse after initial response to CAR T-cell therapy may be antigen-positive, due to CAR T-cell exhaustion or limited persistence, or antigen-negative, due to antigen-modulation on the target cells. Finally, we discuss ongoing efforts to overcome resistance to CAR T-cell therapy with enhanced CAR constructs, manufacturing methods, alternate cell types, combinatorial strategies, and optimization of both pre-infusion conditioning regimens and post-infusion consolidative strategies. EXPERT OPINION There is a continued need for novel approaches to CAR T-cell therapy for both hematologic and solid malignancies to obtain sustained remissions. Opportunities for improvement include development of new targets, optimally combining existing CAR T-cell therapies, and defining the role for adjunctive immune modulators and stem cell transplant in enhancing long-term survival.
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Affiliation(s)
- Alexandra Dreyzin
- Pediatric Oncology Branch, Center of Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Division of Pediatric Oncology, Children's National Hospital, Washington DC, USA
| | - Alexander W Rankin
- Pediatric Oncology Branch, Center of Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Katia Luciani
- School of Medicine, University of Limerick, Limerick, Ireland
| | | | - Nirali N Shah
- Pediatric Oncology Branch, Center of Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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8
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Ruggeri Barbaro N, Drashansky T, Tess K, Djedaini M, Hariri R, He S, van der Touw W, Karasiewicz K. Placental circulating T cells: a novel, allogeneic CAR-T cell platform with preserved T-cell stemness, more favorable cytokine profile, and durable efficacy compared to adult PBMC-derived CAR-T. J Immunother Cancer 2024; 12:e008656. [PMID: 38684370 PMCID: PMC11107807 DOI: 10.1136/jitc-2023-008656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Chimeric antigen receptor (CAR)-T cell quality and stemness are associated with responsiveness, durability, and memory formation, which benefit clinical responses. Autologous T cell starting material across patients with cancer is variable and CAR-T expansion or potency can fail during manufacture. Thus, strategies to develop allogeneic CAR-T platforms including the identification and expansion of T cell subpopulations that correspond with CAR-T potency are an active area of investigation. Here, we compared CAR-T cells generated from healthy adult peripheral blood T cells versus placental circulating T (P-T) cells. METHODS CAR-T cells from healthy adult peripheral blood mononuclear cells (PBMCs) and P-T cells were generated using the same protocol. CAR-T cells were characterized in detail by a combination of multiparameter flow cytometry, functional assays, and RNA sequencing. In vivo antitumor efficacy and persistence of CAR-T cells were evaluated in a Daudi lymphoma xenograft model. RESULTS P-T cells possess stemness advantages compared with T cells from adult PBMCs. P-T cells are uniformly naïve prior to culture initiation, maintain longer telomeres, resist immune checkpoint upregulation, and resist further differentiation compared with PBMC T cells during CD19 CAR-T manufacture. P-T CD19 CAR-T cells are equally cytotoxic as PBMC-CD19 CAR-T cells but produce less interferon gamma in response to lymphoma. Transcriptome analysis shows P-T CD19 CAR-T cells retain a stem-like gene signature, strongly associate with naïve T cells, an early memory phenotype, and a unique CD4 T cell signature compared with PBMC-CD19 CAR-T cells, which enrich for exhaustion and stimulated memory T cell signatures. Consistent with functional data, P-T CD19 CAR-T cells exhibit attenuated inflammatory cytokine and chemokine gene signatures. In a murine in vivo model, P-T CD19 CAR-T cells eliminate lymphoma beyond 90 days. PBMC-CD19 CAR-T cells provide a non-durable benefit, which only delays disease onset. CONCLUSION We identified characteristics of T cell stemness enriched in P-T CD19 CAR-T which are deficient in PBMC-derived products and translate into response durability in vivo. Our findings demonstrate that placental circulating T cells are a valuable cell source for allogeneic CAR-T products. Stemness advantages inherent to P-T cells translate to in vivo persistence advantages and long-term durable activity.
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Affiliation(s)
| | | | | | | | | | - Shuyang He
- Celularity Inc, Florham Park, New Jersey, USA
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Zhu M, Han Y, Gu T, Wang R, Si X, Kong D, Zhao P, Wang X, Li J, Zhai X, Yu Z, Lu H, Li J, Huang H, Qian P. Class I HDAC inhibitors enhance antitumor efficacy and persistence of CAR-T cells by activation of the Wnt pathway. Cell Rep 2024; 43:114065. [PMID: 38578828 DOI: 10.1016/j.celrep.2024.114065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/18/2024] [Accepted: 03/21/2024] [Indexed: 04/07/2024] Open
Abstract
Epigenetic modification shapes differentiation trajectory and regulates the exhaustion state of chimeric antigen receptor T (CAR-T) cells. Limited efficacy induced by terminal exhaustion closely ties with intrinsic transcriptional regulation. However, the comprehensive regulatory mechanisms remain largely elusive. Here, we identify class I histone deacetylase inhibitors (HDACi) as boosters of CAR-T cell function by high-throughput screening of chromatin-modifying drugs, in which M344 and chidamide enhance memory maintenance and resistance to exhaustion of CAR-T cells that induce sustained antitumor efficacy both in vitro and in vivo. Mechanistically, HDACi decrease HDAC1 expression and enhance H3K27ac activity. Multi-omics analyses from RNA-seq, ATAC-seq, and H3K27ac CUT&Tag-seq show that HDACi upregulate expression of TCF4, LEF1, and CTNNB1, which subsequently activate the canonical Wnt/β-catenin pathway. Collectively, our findings elucidate the functional roles of class I HDACi in enhancing CAR-T cell function, which provides the basis and therapeutic targets for synergic combination of CAR-T cell therapy and HDACi treatment.
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Affiliation(s)
- Meng Zhu
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China
| | - Yingli Han
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China
| | - Tianning Gu
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China; Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Rui Wang
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China
| | - Xiaohui Si
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China; Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Delin Kong
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China; Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peng Zhao
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China
| | - Xiujian Wang
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China; Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinxin Li
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China
| | - Xingyuan Zhai
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China; Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zebin Yu
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China
| | - Huan Lu
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China
| | - Jingyi Li
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China
| | - He Huang
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China; Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Pengxu Qian
- Center for Stem Cell and Regenerative Medicine and Bone Marrow Transplantation Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Liangzhu Laboratory, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China; Institute of Hematology, Zhejiang University & Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou 310058, China.
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Hanssens H, Meeus F, De Vlaeminck Y, Lecocq Q, Puttemans J, Debie P, De Groof TWM, Goyvaerts C, De Veirman K, Breckpot K, Devoogdt N. Scrutiny of chimeric antigen receptor activation by the extracellular domain: experience with single domain antibodies targeting multiple myeloma cells highlights the need for case-by-case optimization. Front Immunol 2024; 15:1389018. [PMID: 38720898 PMCID: PMC11077437 DOI: 10.3389/fimmu.2024.1389018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/02/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Multiple myeloma (MM) remains incurable, despite the advent of chimeric antigen receptor (CAR)-T cell therapy. This unfulfilled potential can be attributed to two untackled issues: the lack of suitable CAR targets and formats. In relation to the former, the target should be highly expressed and reluctant to shedding; two characteristics that are attributed to the CS1-antigen. Furthermore, conventional CARs rely on scFvs for antigen recognition, yet this withholds disadvantages, mainly caused by the intrinsic instability of this format. VHHs have been proposed as valid scFv alternatives. We therefore intended to develop VHH-based CAR-T cells, targeting CS1, and to identify VHHs that induce optimal CAR-T cell activation together with the VHH parameters required to achieve this. Methods CS1-specific VHHs were generated, identified and fully characterized, in vitro and in vivo. Next, they were incorporated into second-generation CARs that only differ in their antigen-binding moiety. Reporter T-cell lines were lentivirally transduced with the different VHH-CARs and CAR-T cell activation kinetics were evaluated side-by-side. Affinity, cell-binding capacity, epitope location, in vivo behavior, binding distance, and orientation of the CAR-T:MM cell interaction pair were investigated as predictive parameters for CAR-T cell activation. Results Our data show that the VHHs affinity for its target antigen is relatively predictive for its in vivo tumor-tracing capacity, as tumor uptake generally decreased with decreasing affinity in an in vivo model of MM. This does not hold true for their CAR-T cell activation potential, as some intermediate affinity-binding VHHs proved surprisingly potent, while some higher affinity VHHs failed to induce equal levels of T-cell activation. This could not be attributed to cell-binding capacity, in vivo VHH behavior, epitope location, cell-to-cell distance or binding orientation. Hence, none of the investigated parameters proved to have significant predictive value for the extent of CAR-T cell activation. Conclusions We gained insight into the predictive parameters of VHHs in the CAR-context using a VHH library against CS1, a highly relevant MM antigen. As none of the studied VHH parameters had predictive value, defining VHHs for optimal CAR-T cell activation remains bound to serendipity. These findings highlight the importance of screening multiple candidates.
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Affiliation(s)
- Heleen Hanssens
- Laboratory of Molecular Imaging and Therapy (MITH), Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Laboratory for Molecular and Cellular Therapy (LMCT), Translational Oncology Research Center, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Laboratory for Hematology and Immunology (HEIM), Translational Oncology Research Center, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Fien Meeus
- Laboratory for Molecular and Cellular Therapy (LMCT), Translational Oncology Research Center, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Yannick De Vlaeminck
- Laboratory for Molecular and Cellular Therapy (LMCT), Translational Oncology Research Center, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Quentin Lecocq
- Laboratory for Molecular and Cellular Therapy (LMCT), Translational Oncology Research Center, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Janik Puttemans
- Laboratory of Molecular Imaging and Therapy (MITH), Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Pieterjan Debie
- Laboratory of Molecular Imaging and Therapy (MITH), Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Timo W. M. De Groof
- Laboratory of Molecular Imaging and Therapy (MITH), Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Cleo Goyvaerts
- Laboratory for Molecular and Cellular Therapy (LMCT), Translational Oncology Research Center, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kim De Veirman
- Laboratory for Hematology and Immunology (HEIM), Translational Oncology Research Center, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Karine Breckpot
- Laboratory for Molecular and Cellular Therapy (LMCT), Translational Oncology Research Center, Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nick Devoogdt
- Laboratory of Molecular Imaging and Therapy (MITH), Department of Biomedical Sciences, Vrije Universiteit Brussel, Brussels, Belgium
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11
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Sakunrangsit N, Khuisangeam N, Inthanachai T, Yodsurang V, Taechawattananant P, Suppipat K, Tawinwung S. Incorporating IL7 receptor alpha signaling in the endodomain of B7H3-targeting chimeric antigen receptor T cells mediates antitumor activity in glioblastoma. Cancer Immunol Immunother 2024; 73:98. [PMID: 38619641 PMCID: PMC11018726 DOI: 10.1007/s00262-024-03685-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/19/2024] [Indexed: 04/16/2024]
Abstract
CAR-T-cell therapy has shown promise in treating hematological malignancies but faces challenges in treating solid tumors due to impaired T-cell function in the tumor microenvironment. To provide optimal T-cell activation, we developed a B7 homolog 3 protein (B7H3)-targeting CAR construct consisting of three activation signals: CD3ζ (signal 1), 41BB (signal 2), and the interleukin 7 receptor alpha (IL7Rα) cytoplasmic domain (signal 3). We generated B7H3 CAR-T cells with different lengths of the IL7Rα cytoplasmic domain, including the full length (IL7R-L), intermediate length (IL7R-M), and short length (IL7R-S) domains, and evaluated their functionality in vitro and in vivo. All the B7H3-IL7Rα CAR-T cells exhibited a less differentiated phenotype and effectively eliminated B7H3-positive glioblastoma in vitro. Superiority was found in B7H3 CAR-T cells contained the short length of the IL7Rα cytoplasmic domain. Integration of the IL7R-S cytoplasmic domain maintained pSTAT5 activation and increased T-cell proliferation while reducing activation-induced cell death. Moreover, RNA-sequencing analysis of B7H3-IL7R-S CAR-T cells after coculture with a glioblastoma cell line revealed downregulation of proapoptotic genes and upregulation of genes associated with T-cell proliferation compared with those in 2nd generation B7H3 CAR-T cells. In animal models, compared with conventional CAR-T cells, B7H3-IL7R-S CAR-T cells suppressed tumor growth and prolonged overall survival. Our study demonstrated the therapeutic potential of IL7Rα-incorporating CAR-T cells for glioblastoma treatment, suggesting a promising strategy for augmenting the effectiveness of CAR-T cell therapy.
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Affiliation(s)
- Nithidol Sakunrangsit
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Nattarika Khuisangeam
- Medical Microbiology, Interdisciplinary and International Program, Graduate School, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thananya Inthanachai
- Medical Microbiology, Interdisciplinary and International Program, Graduate School, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Varalee Yodsurang
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Pasrawin Taechawattananant
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Koramit Suppipat
- Department of Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Cellular Immunotherapy Research Unit, Chulalongkorn University, Bangkok, 10330, Thailand
- Thailand Hub of Talents in Cancer Immunotherapy (TTCI), Bangkok, 10330, Thailand
| | - Supannikar Tawinwung
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
- Cellular Immunotherapy Research Unit, Chulalongkorn University, Bangkok, 10330, Thailand.
- Thailand Hub of Talents in Cancer Immunotherapy (TTCI), Bangkok, 10330, Thailand.
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12
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Ochi T, Konishi T, Takenaka K. Bispecific antibodies for multiple myeloma: past, present and future. Int J Hematol 2024:10.1007/s12185-024-03766-4. [PMID: 38613724 DOI: 10.1007/s12185-024-03766-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/15/2024]
Abstract
Despite the development of various therapeutic agents, multiple myeloma remains incurable. Recently, T-cell redirected immunotherapy has become a promising strategy for the treatment of refractory myeloma. Clinical trials using chimeric antigen receptor (CAR)-T cells and bispecific antibodies have demonstrated successful anti-myeloma responses in triple-class-refractory patients. However, unique and unwanted immune effects associated with on-target/off-target reactivity of activated immune cells need to be considered and properly managed. This review summarizes recent advances in bispecific antibodies for the treatment of refractory myeloma. It outlines the history of their development, along with a discussion of their mechanisms of action and their current and potential future role in myeloma therapy. As more evidence emerges to inform the timing of CAR-T-cell therapy, the results of clinical trials and off-the-shelf nature of bispecifics also suggest the timing of their treatment. These findings will promote further development and application of bispecifics for refractory myeloma in combination with other appropriate agents.
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Affiliation(s)
- Toshiki Ochi
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan.
- Division of Immune Regulation, Proteo-Science Center, Ehime University, Toon, Ehime, 791-0295, Japan.
| | - Tatsuya Konishi
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan
| | - Katsuto Takenaka
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan
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13
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Hoenigl M, Arastehfar A, Arendrup MC, Brüggemann R, Carvalho A, Chiller T, Chen S, Egger M, Feys S, Gangneux JP, Gold JAW, Groll AH, Heylen J, Jenks JD, Krause R, Lagrou K, Lamoth F, Prattes J, Sedik S, Wauters J, Wiederhold NP, Thompson GR. Novel antifungals and treatment approaches to tackle resistance and improve outcomes of invasive fungal disease. Clin Microbiol Rev 2024:e0007423. [PMID: 38602408 DOI: 10.1128/cmr.00074-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Abstract
SUMMARYFungal infections are on the rise, driven by a growing population at risk and climate change. Currently available antifungals include only five classes, and their utility and efficacy in antifungal treatment are limited by one or more of innate or acquired resistance in some fungi, poor penetration into "sequestered" sites, and agent-specific side effect which require frequent patient reassessment and monitoring. Agents with novel mechanisms, favorable pharmacokinetic (PK) profiles including good oral bioavailability, and fungicidal mechanism(s) are urgently needed. Here, we provide a comprehensive review of novel antifungal agents, with both improved known mechanisms of actions and new antifungal classes, currently in clinical development for treating invasive yeast, mold (filamentous fungi), Pneumocystis jirovecii infections, and dimorphic fungi (endemic mycoses). We further focus on inhaled antifungals and the role of immunotherapy in tackling fungal infections, and the specific PK/pharmacodynamic profiles, tissue distributions as well as drug-drug interactions of novel antifungals. Finally, we review antifungal resistance mechanisms, the role of use of antifungal pesticides in agriculture as drivers of drug resistance, and detail detection methods for antifungal resistance.
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Affiliation(s)
- Martin Hoenigl
- Department of Internal Medicine, Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria
- BiotechMed-Graz, Graz, Austria
| | - Amir Arastehfar
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Maiken Cavling Arendrup
- Unit of Mycology, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Roger Brüggemann
- Department of Pharmacy and Radboudumc Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboudumc-CWZ Center of Expertise in Mycology, Nijmegen, The Netherlands
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharon Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW South Wales Health Pathology, Westmead Hospital, Westmead, Australia
- The University of Sydney, Sydney, Australia
| | - Matthias Egger
- Department of Internal Medicine, Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria
| | - Simon Feys
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Jean-Pierre Gangneux
- Centre National de Référence des Mycoses et Antifongiques LA-AspC Aspergilloses chroniques, European Excellence Center for Medical Mycology (ECMM EC), Centre hospitalier Universitaire de Rennes, Rennes, France
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) UMR_S 1085, Rennes, France
| | - Jeremy A W Gold
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Andreas H Groll
- Department of Pediatric Hematology/Oncology and Infectious Disease Research Program, Center for Bone Marrow Transplantation, University Children's Hospital, Muenster, Germany
| | - Jannes Heylen
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Jeffrey D Jenks
- Department of Public Health, Durham County, Durham, North Carolina, USA
- Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA
| | - Robert Krause
- Department of Internal Medicine, Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria
- BiotechMed-Graz, Graz, Austria
| | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Laboratory Medicine and National Reference Center for Mycosis, University Hospitals Leuven, Leuven, Belgium
| | - Frédéric Lamoth
- Department of Laboratory Medicine and Pathology, Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Department of Medicine, Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Juergen Prattes
- Department of Internal Medicine, Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria
- BiotechMed-Graz, Graz, Austria
| | - Sarah Sedik
- Department of Internal Medicine, Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, Austria
| | - Joost Wauters
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Nathan P Wiederhold
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - George R Thompson
- Department of Internal Medicine, Division of Infectious Diseases University of California-Davis Medical Center, Sacramento, California, USA
- Department of Medical Microbiology and Immunology, University of California-Davis, Davis, California, USA
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14
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Huang J, Yang Q, Wang W, Huang J. CAR products from novel sources: a new avenue for the breakthrough in cancer immunotherapy. Front Immunol 2024; 15:1378739. [PMID: 38665921 PMCID: PMC11044028 DOI: 10.3389/fimmu.2024.1378739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Chimeric antigen receptor (CAR) T cell therapy has transformed cancer immunotherapy. However, significant challenges limit its application beyond B cell-driven malignancies, including limited clinical efficacy, high toxicity, and complex autologous cell product manufacturing. Despite efforts to improve CAR T cell therapy outcomes, there is a growing interest in utilizing alternative immune cells to develop CAR cells. These immune cells offer several advantages, such as major histocompatibility complex (MHC)-independent function, tumor microenvironment (TME) modulation, and increased tissue infiltration capabilities. Currently, CAR products from various T cell subtypes, innate immune cells, hematopoietic progenitor cells, and even exosomes are being explored. These CAR products often show enhanced antitumor efficacy, diminished toxicity, and superior tumor penetration. With these benefits in mind, numerous clinical trials are underway to access the potential of these innovative CAR cells. This review aims to thoroughly examine the advantages, challenges, and existing insights on these new CAR products in cancer treatment.
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Affiliation(s)
| | | | - Wen Wang
- Department of Hematology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Juan Huang
- Department of Hematology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
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15
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Xiang M, Li H, Zhan Y, Ma D, Gao Q, Fang Y. Functional CRISPR screens in T cells reveal new opportunities for cancer immunotherapies. Mol Cancer 2024; 23:73. [PMID: 38581063 PMCID: PMC10996278 DOI: 10.1186/s12943-024-01987-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/25/2024] [Indexed: 04/07/2024] Open
Abstract
T cells are fundamental components in tumour immunity and cancer immunotherapies, which have made immense strides and revolutionized cancer treatment paradigm. However, recent studies delineate the predicament of T cell dysregulation in tumour microenvironment and the compromised efficacy of cancer immunotherapies. CRISPR screens enable unbiased interrogation of gene function in T cells and have revealed functional determinators, genetic regulatory networks, and intercellular interactions in T cell life cycle, thereby providing opportunities to revamp cancer immunotherapies. In this review, we briefly described the central roles of T cells in successful cancer immunotherapies, comprehensively summarised the studies of CRISPR screens in T cells, elaborated resultant master genes that control T cell activation, proliferation, fate determination, effector function, and exhaustion, and highlighted genes (BATF, PRDM1, and TOX) and signalling cascades (JAK-STAT and NF-κB pathways) that extensively engage in multiple branches of T cell responses. In conclusion, this review bridged the gap between discovering element genes to a specific process of T cell activities and apprehending these genes in the global T cell life cycle, deepened the understanding of T cell biology in tumour immunity, and outlined CRISPR screens resources that might facilitate the development and implementation of cancer immunotherapies in the clinic.
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Affiliation(s)
- Minghua Xiang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Cancer Invasion and Metastasis (Ministry of Education), Hubei Key Laboratory of Tumor Invasion and Metastasis, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huayi Li
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Cancer Invasion and Metastasis (Ministry of Education), Hubei Key Laboratory of Tumor Invasion and Metastasis, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanyuan Zhan
- Department of Plastic and Cosmetic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ding Ma
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Cancer Invasion and Metastasis (Ministry of Education), Hubei Key Laboratory of Tumor Invasion and Metastasis, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qinglei Gao
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- Key Laboratory of Cancer Invasion and Metastasis (Ministry of Education), Hubei Key Laboratory of Tumor Invasion and Metastasis, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yong Fang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- Key Laboratory of Cancer Invasion and Metastasis (Ministry of Education), Hubei Key Laboratory of Tumor Invasion and Metastasis, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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16
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Jamali A, Ho N, Braun A, Adabi E, Thalheimer FB, Buchholz CJ. Early induction of cytokine release syndrome by rapidly generated CAR T cells in preclinical models. EMBO Mol Med 2024; 16:784-804. [PMID: 38514793 PMCID: PMC11018744 DOI: 10.1038/s44321-024-00055-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/23/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024] Open
Abstract
Cytokine release syndrome (CRS) is a significant side-effect of conventional chimeric antigen receptor (CAR) T-cell therapy. To facilitate patient accessibility, short-term (st) CAR T cells, which are administered to patients only 24 h after vector exposure, are in focus of current investigations. Their impact on the incidence and severity of CRS has been poorly explored. Here, we evaluated CD19-specific stCAR T cells in preclinical models. In co-culture with tumor cells and monocytes, stCAR T cells exhibited anti-tumoral activity and potent release of CRS-related cytokines (IL-6, IFN-γ, TNF-α, GM-CSF, IL-2, IL-10). When administered to NSG-SGM3 mice, stCAR T cells, but not conventional CAR T cells, induced severe acute adverse events within 24 h, including hypothermia and weight loss, as well as high body scores, independent of the presence of tumor target cells. Human (IFN-γ, TNF-α, IL-2, IL-10) and murine (MCP-1, IL-6, G-CSF) cytokines, typical for severe CRS, were systemically elevated. Our data highlight potential safety risks of rapidly manufactured CAR T cells and suggest NSG-SGM3 mice as sensitive model for their preclinical safety evaluation.
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Affiliation(s)
- Arezoo Jamali
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
| | - Naphang Ho
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
- Frankfurt Cancer Institute, Goethe University, Frankfurt am Main, Germany
| | - Angela Braun
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elham Adabi
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
| | - Frederic B Thalheimer
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
- Frankfurt Cancer Institute, Goethe University, Frankfurt am Main, Germany
- Hematology, Cell and Gene Therapy (HZG), Paul-Ehrlich-Institut, Langen, Germany
| | - Christian J Buchholz
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany.
- Frankfurt Cancer Institute, Goethe University, Frankfurt am Main, Germany.
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany.
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17
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Brown CE, Hibbard JC, Alizadeh D, Blanchard MS, Natri HM, Wang D, Ostberg JR, Aguilar B, Wagner JR, Paul JA, Starr R, Wong RA, Chen W, Shulkin N, Aftabizadeh M, Filippov A, Chaudhry A, Ressler JA, Kilpatrick J, Myers-McNamara P, Chen M, Wang LD, Rockne RC, Georges J, Portnow J, Barish ME, D'Apuzzo M, Banovich NE, Forman SJ, Badie B. Locoregional delivery of IL-13Rα2-targeting CAR-T cells in recurrent high-grade glioma: a phase 1 trial. Nat Med 2024; 30:1001-1012. [PMID: 38454126 PMCID: PMC11031404 DOI: 10.1038/s41591-024-02875-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/15/2024] [Indexed: 03/09/2024]
Abstract
Chimeric antigen receptor T cell (CAR-T) therapy is an emerging strategy to improve treatment outcomes for recurrent high-grade glioma, a cancer that responds poorly to current therapies. Here we report a completed phase I trial evaluating IL-13Rα2-targeted CAR-T cells in 65 patients with recurrent high-grade glioma, the majority being recurrent glioblastoma (rGBM). Primary objectives were safety and feasibility, maximum tolerated dose/maximum feasible dose and a recommended phase 2 dose plan. Secondary objectives included overall survival, disease response, cytokine dynamics and tumor immune contexture biomarkers. This trial evolved to evaluate three routes of locoregional T cell administration (intratumoral (ICT), intraventricular (ICV) and dual ICT/ICV) and two manufacturing platforms, culminating in arm 5, which utilized dual ICT/ICV delivery and an optimized manufacturing process. Locoregional CAR-T cell administration was feasible and well tolerated, and as there were no dose-limiting toxicities across all arms, a maximum tolerated dose was not determined. Probable treatment-related grade 3+ toxicities were one grade 3 encephalopathy and one grade 3 ataxia. A clinical maximum feasible dose of 200 × 106 CAR-T cells per infusion cycle was achieved for arm 5; however, other arms either did not test or achieve this dose due to manufacturing feasibility. A recommended phase 2 dose will be refined in future studies based on data from this trial. Stable disease or better was achieved in 50% (29/58) of patients, with two partial responses, one complete response and a second complete response after additional CAR-T cycles off protocol. For rGBM, median overall survival for all patients was 7.7 months and for arm 5 was 10.2 months. Central nervous system increases in inflammatory cytokines, including IFNγ, CXCL9 and CXCL10, were associated with CAR-T cell administration and bioactivity. Pretreatment intratumoral CD3 T cell levels were positively associated with survival. These findings demonstrate that locoregional IL-13Rα2-targeted CAR-T therapy is safe with promising clinical activity in a subset of patients. ClinicalTrials.gov Identifier: NCT02208362 .
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Affiliation(s)
- Christine E Brown
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA.
| | - Jonathan C Hibbard
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Darya Alizadeh
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - M Suzette Blanchard
- Department of Computational and Quantitative Medicine, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Heini M Natri
- The Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Dongrui Wang
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
- Bone Marrow Transplantation Center, the First Affiliated Hospital, and Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China
| | - Julie R Ostberg
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Brenda Aguilar
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Jamie R Wagner
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Jinny A Paul
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Renate Starr
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Robyn A Wong
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Wuyang Chen
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Noah Shulkin
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Maryam Aftabizadeh
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Aleksandr Filippov
- Department of Neurosurgery, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Ammar Chaudhry
- Department of Diagnostic Radiology, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Julie A Ressler
- Department of Diagnostic Radiology, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Julie Kilpatrick
- Department of Clinical Research, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Paige Myers-McNamara
- Department of Neurosurgery, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Mike Chen
- Department of Neurosurgery, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Leo D Wang
- Departments of Immuno-Oncology and Pediatrics, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Russell C Rockne
- Department of Computational and Quantitative Medicine, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Joseph Georges
- Department of Neurosurgery, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Jana Portnow
- Department of Medical Oncology, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Michael E Barish
- Department of Stem Cell Biology & Regenerative Medicine, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Massimo D'Apuzzo
- Department of Pathology, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | | | - Stephen J Forman
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
| | - Behnam Badie
- Department of Neurosurgery, City of Hope Beckman Research Institute and Medical Center, Duarte, CA, USA
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18
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Niu Q, Zhang H, Wang F, Xu X, Luo Y, He B, Shi M, Jiang E, Feng X. GSNOR overexpression enhances CAR-T cell stemness and anti-tumor function by enforcing mitochondrial fitness. Mol Ther 2024:S1525-0016(24)00211-9. [PMID: 38549378 DOI: 10.1016/j.ymthe.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/27/2024] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
Chimeric antigen receptor-T (CAR-T) cell has been developed as a promising agent for patients with refractory or relapsed lymphoma and leukemia, but not all the recipients could achieve a long-lasting remission. The limited capacity of in vivo expansion and memory differentiation post activation is one of the major reasons for suboptimal CAR-T therapeutic efficiency. Nitric oxide (NO) plays multifaceted roles in mitochondrial dynamics and T cell activation, but its function on CAR-T cell persistence and anti-tumor efficacy remains unknown. Herein, we found the continuous signaling from CAR not only promotes excessive NO production, but also suppressed S-nitrosoglutathione reductase (GSNOR) expression in T cells, which collectively led to increased protein S-nitrosylation, resulting in impaired mitochondrial fitness and deficiency of T cell stemness. Intriguingly, enforced expression of GSNOR promoted memory differentiation of CAR-T cell after immune activation, rendered CAR-T better resistance to mitochondrial dysfunction, further enhanced CAR-T cell expansion and anti-tumor capacity in vitro and in a mouse tumor model. Thus, we revealed a critical role of NO in restricting CAR-T cell persistence and functionality, and defined that GSNOR overexpression may provide a solution to combat NO stress and render patients with more durable protection from CAR-T therapy.
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Affiliation(s)
- Qing Niu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China; Central Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Haixiao Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Fang Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China; Department of Hematology, Hematology Research Center of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Xing Xu
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin 300060, China; Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Yuechen Luo
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Baolin He
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Mingxia Shi
- Department of Hematology, Hematology Research Center of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Erlie Jiang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China.
| | - Xiaoming Feng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Gene Therapy for Blood Diseases, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Tianjin 300020, China; Tianjin Institutes of Health Science, Tianjin 301600, China; Central Laboratory, Fujian Medical University Union Hospital, Fuzhou 350001, China.
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19
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Kagoya Y. Cytokine signaling in chimeric antigen receptor T-cell therapy. Int Immunol 2024; 36:49-56. [PMID: 37591521 PMCID: PMC10872714 DOI: 10.1093/intimm/dxad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/15/2023] [Indexed: 08/19/2023] Open
Abstract
Adoptive immunotherapy using chimeric antigen-receptor (CAR)-engineered T cells can induce robust antitumor responses against hematologic malignancies. However, its efficacy is not durable in the majority of the patients, warranting further improvement of T-cell functions. Cytokine signaling is one of the key cascades regulating T-cell survival and effector functions. In addition to cytokines that use the common γ chain as a receptor subunit, multiple cytokines regulate T-cell functions directly or indirectly. Modulating cytokine signaling in CAR-T cells by genetic engineering is one promising strategy to augment their therapeutic efficacy. These strategies include ectopic expression of cytokines, cytokine receptors, and synthetic molecules that mimic endogenous cytokine signaling. Alternatively, autocrine IL-2 signaling can be augmented through reprogramming of CAR-T cell properties through transcriptional and epigenetic modification. On the other hand, cytokine production by CAR-T cells triggers systemic inflammatory responses, which mainly manifest as adverse events such as cytokine-release syndrome (CRS) and neurotoxicity. In addition to inhibiting direct inflammatory mediators such as IL-6 and IL-1 released from activated macrophages, suppression of T-cell-derived cytokines associated with the priming of macrophages can be accomplished through genetic modification of CAR-T cells. In this review, I will outline recently developed synthetic biology approaches to exploit cytokine signaling to enhance CAR-T cell functions. I will also discuss therapeutic target molecules to prevent or alleviate CAR-T cell-related toxicities.
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Affiliation(s)
- Yuki Kagoya
- Division of Tumor Immunology, Institute for Advanced Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
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20
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Ayala Ceja M, Khericha M, Harris CM, Puig-Saus C, Chen YY. CAR-T cell manufacturing: Major process parameters and next-generation strategies. J Exp Med 2024; 221:e20230903. [PMID: 38226974 PMCID: PMC10791545 DOI: 10.1084/jem.20230903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/02/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024] Open
Abstract
Chimeric antigen receptor (CAR)-T cell therapies have demonstrated strong curative potential and become a critical component in the array of B-cell malignancy treatments. Successful deployment of CAR-T cell therapies to treat hematologic and solid cancers, as well as other indications such as autoimmune diseases, is dependent on effective CAR-T cell manufacturing that impacts not only product safety and efficacy but also overall accessibility to patients in need. In this review, we discuss the major process parameters of autologous CAR-T cell manufacturing, as well as regulatory considerations and ongoing developments that will enable the next generation of CAR-T cell therapies.
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Affiliation(s)
- Melanie Ayala Ceja
- Department of Microbiology, Immunology, and Molecular Genetics, University of California−Los Angeles, Los Angeles, CA, USA
| | - Mobina Khericha
- Department of Microbiology, Immunology, and Molecular Genetics, University of California−Los Angeles, Los Angeles, CA, USA
| | - Caitlin M. Harris
- Department of Microbiology, Immunology, and Molecular Genetics, University of California−Los Angeles, Los Angeles, CA, USA
| | - Cristina Puig-Saus
- Department of Medicine, University of California−Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California−Los Angeles, Los Angeles, CA, USA
- Parker Institute for Cancer Immunotherapy Center at University of California−Los Angeles, Los Angeles, CA, USA
| | - Yvonne Y. Chen
- Department of Microbiology, Immunology, and Molecular Genetics, University of California−Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California−Los Angeles, Los Angeles, CA, USA
- Parker Institute for Cancer Immunotherapy Center at University of California−Los Angeles, Los Angeles, CA, USA
- Department of Chemical and Biomolecular Engineering, University of California−Los Angeles, Los Angeles, CA, USA
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21
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Ong SY, Chen Y, Tan MSY, Ho AYL, Hwang WYK, Lim FLWI. Current perspectives on resistance to chimeric antigen receptor T-cell therapy and strategies to improve efficacy in B-cell lymphoma. Eur J Haematol 2024; 112:144-152. [PMID: 36987995 DOI: 10.1111/ejh.13964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/11/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023]
Abstract
Although chimeric antigen receptor (CAR) T-cell therapy has demonstrated remarkable efficacy in patients with chemo-refractory B-cell lymphoma, a significant portion is refractory or relapse. Resistance is a major barrier to improving treatment efficacy and long-term survival in CAR T-cell therapy, and clinicians have very limited tools to discriminate a priori patients who will or will not respond to treatment. While CD19-negative relapses due to loss of target antigen is well described, it accounts for only about 30% of cases with treatment failure. Recent efforts have shed light on mechanisms of CD19-positive relapse due to tumor intrinsic resistance, T-cell quality/manufacturing, or CAR T-cell exhaustion mediated by hostile tumor microenvironment. Here, we review the latest updates of preclinical and clinical trials to investigate the mechanisms of resistance and relapse post CAR T-cell therapy in B cell lymphoma and discuss novel treatment strategies to overcome resistance as well as advances that are useful for a CAR T therapist to optimize and personalize CAR T-cell therapy.
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Affiliation(s)
- Shin Yeu Ong
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Yunxin Chen
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Melinda Si Yun Tan
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | | | - William Ying Khee Hwang
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
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22
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Filosto S, Vardhanabhuti S, Canales MA, Poiré X, Lekakis LJ, de Vos S, Portell CA, Wang Z, To C, Schupp M, Poddar S, Trinh T, Warren CM, Aguilar EG, Budka J, Cheng P, Chou J, Bot A, Shen RR, Westin JR. Product Attributes of CAR T-cell Therapy Differentially Associate with Efficacy and Toxicity in Second-line Large B-cell Lymphoma (ZUMA-7). Blood Cancer Discov 2024; 5:21-33. [PMID: 37983485 PMCID: PMC10772511 DOI: 10.1158/2643-3230.bcd-23-0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/05/2023] [Accepted: 11/17/2023] [Indexed: 11/22/2023] Open
Abstract
Treatment resistance and toxicities remain a risk following chimeric antigen receptor (CAR) T-cell therapy. Herein, we report pharmacokinetics, pharmacodynamics, and product and apheresis attributes associated with outcomes among patients with relapsed/refractory large B-cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel) in ZUMA-7. Axi-cel peak expansion associated with clinical response and toxicity, but not response durability. In apheresis material and final product, a naive T-cell phenotype (CCR7+CD45RA+) expressing CD27 and CD28 associated with improved response durability, event-free survival, progression-free survival, and a lower number of prior therapies. This phenotype was not associated with high-grade cytokine release syndrome (CRS) or neurologic events. Higher baseline and postinfusion levels of serum inflammatory markers associated with differentiated/effector products, reduced efficacy, and increased CRS and neurologic events, thus suggesting targets for intervention. These data support better outcomes with earlier CAR T-cell intervention and may improve patient care by informing on predictive biomarkers and development of next-generation products. SIGNIFICANCE In ZUMA-7, the largest randomized CAR T-cell trial in LBCL, a naive T-cell product phenotype (CCR7+CD45RA+) expressing CD27 and CD28 associated with improved efficacy, decreased toxicity, and a lower number of prior therapies, supporting earlier intervention with CAR T-cell therapy. In addition, targets for improvement of therapeutic index are proposed. This article is featured in Selected Articles from This Issue, p. 4.
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Affiliation(s)
| | | | | | - Xavier Poiré
- Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Lazaros J. Lekakis
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, Florida
| | - Sven de Vos
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | | | - Zixing Wang
- Kite, a Gilead Company, Santa Monica, California
| | - Christina To
- Kite, a Gilead Company, Santa Monica, California
| | - Marco Schupp
- Kite, a Gilead Company, Santa Monica, California
| | | | - Tan Trinh
- Kite, a Gilead Company, Santa Monica, California
| | | | | | - Justin Budka
- Kite, a Gilead Company, Santa Monica, California
| | - Paul Cheng
- Kite, a Gilead Company, Santa Monica, California
| | - Justin Chou
- Kite, a Gilead Company, Santa Monica, California
| | - Adrian Bot
- Kite, a Gilead Company, Santa Monica, California
| | | | - Jason R. Westin
- The University of Texas MD Anderson Cancer Center, Houston, Texas
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23
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Su H, Anthony-Gonda K, Orentas RJ, Dropulić B, Goldstein H. Generation of Anti-HIV CAR-T Cells for Preclinical Research. Methods Mol Biol 2024; 2807:287-298. [PMID: 38743236 DOI: 10.1007/978-1-0716-3862-0_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
The inability of people living with HIV (PLWH) to eradicate human immunodeficiency virus (HIV) infection is due in part to the inadequate HIV-specific cellular immune response. The antiviral function of cytotoxic CD8+ T cells, which are crucial for HIV control, is impaired during chronic viral infection because of viral escape mutations, immune exhaustion, HIV antigen downregulation, inflammation, and apoptosis. In addition, some HIV-infected cells either localize to tissue sanctuaries inaccessible to CD8+ T cells or are intrinsically resistant to CD8+ T cell killing. The novel design of synthetic chimeric antigen receptors (CARs) that enable T cells to target specific antigens has led to the development of potent and effective CAR-T cell therapies. While initial clinical trials using anti-HIV CAR-T cells performed over 20 years ago showed limited anti-HIV effects, the improved CAR-T cell design, which enabled its success in treating cancer, has reinstated CAR-T cell therapy as a strategy for HIV cure with notable progress being made in the recent decade.Effective CAR-T cell therapy against HIV infection requires the generation of anti-HIV CAR-T cells with potent in vivo activity against HIV-infected cells. Preclinical evaluation of anti-HIV efficacy of CAR-T cells and their safety is fundamental for supporting the initiation of subsequent clinical trials in PLWH. For these preclinical studies, we developed a novel humanized mouse model supporting in vivo HIV infection, the development of viremia, and the evaluation of novel HIV therapeutics. Preclinical assessment of anti-HIV CAR-T cells using this mouse model involves a multistep process including peripheral blood mononuclear cells (PBMCs) harvested from human donors, T cell purification, ex vivo T cell activation, transduction with lentiviral vectors encoding an anti-HIV CAR, CAR-T cell expansion and infusion in mice intrasplenically injected with autologous PBMCs followed by the determination of CAR-T cell capacity for HIV suppression. Each of the steps described in the following protocol were optimized in the lab to maximize the quantity and quality of the final anti-HIV CAR-T cell products.
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MESH Headings
- Humans
- Animals
- Receptors, Chimeric Antigen/immunology
- Receptors, Chimeric Antigen/genetics
- Receptors, Chimeric Antigen/metabolism
- Mice
- HIV Infections/immunology
- HIV Infections/therapy
- HIV Infections/virology
- Immunotherapy, Adoptive/methods
- Receptors, Antigen, T-Cell/immunology
- Receptors, Antigen, T-Cell/genetics
- Receptors, Antigen, T-Cell/metabolism
- CD8-Positive T-Lymphocytes/immunology
- HIV-1/immunology
- T-Lymphocytes/immunology
- Transduction, Genetic
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Affiliation(s)
- Hang Su
- Departments of Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, USA.
| | | | | | | | - Harris Goldstein
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
- Departments of Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, USA.
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24
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Fischer L, Grieb N, Platzbecker U, Vucinic V, Merz M. CAR T cell therapy in multiple myeloma, where are we now and where are we heading for? Eur J Haematol 2024; 112:19-27. [PMID: 37547971 DOI: 10.1111/ejh.14051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023]
Abstract
The introduction of chimeric antigen receptor (CAR) T cells revolutionized treatment of relapsed and refractory multiple myeloma (RRMM) in recent years. Currently, two CAR T cell products-idecabtagene vicleucel and ciltacabtagene autoleucel-are approved in the United States and the European Union to treat patients with three prior lines of therapy, including a proteasome inhibitor, an immunomodulatory drug, and an anti-CD38 antibody. Moreover, seminal phase III trials of both agents in earlier lines of therapy have been published recently. Despite unprecedented rates of deep and lasting remissions in RRMM, there are still areas of uncertainty regarding the optimal use and distribution of CAR T cells in multiple myeloma. In the current review, we discuss the available data on approved CAR T cell products as well as unmet clinical needs and ongoing developments to optimize usage of this promising treatment modality in multiple myeloma.
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Affiliation(s)
- Luise Fischer
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Nora Grieb
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
| | - Uwe Platzbecker
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Vladan Vucinic
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Maximilian Merz
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
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25
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Casucci M, Bonini C, Ruggiero E. Epigenetic checkpoints regulate the fate and function of CAR-T cells. Nat Immunol 2024; 25:4-6. [PMID: 38168961 DOI: 10.1038/s41590-023-01708-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
- Monica Casucci
- Innovative Immunotherapies Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Bonini
- Università Vita-Salute San Raffaele, Milano, Italy
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Eliana Ruggiero
- Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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26
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Slavkovic-Lukic D, Fioravanti J, Martín-Santos A, Han E, Zhou J, Gattinoni L. Rapid Screening of CAR T Cell Functional Improvement Strategies by Highly Multiplexed Single-Cell Secretomics. Methods Mol Biol 2024; 2748:135-149. [PMID: 38070113 DOI: 10.1007/978-1-0716-3593-3_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The functional fitness of CAR T cells plays a crucial role in determining their clinical efficacy. Several strategies are being explored to increase cellular fitness, but screening these approaches in vivo is expensive and time-consuming, limiting the number of strategies that can be tested at one time. The presence of polyfunctional CAR T cells has emerged as a critical parameter correlating with clinical responses. However, even sophisticated multiplexed secretomic assays often fail to detect differences in cytokine release due to the functional heterogeneity of CAR T cell products. Here, we describe a highly multiplexed single-cell secretomic assay based on the IsoLight platform to rapidly evaluate the impact of new pharmacologic or gene-engineering approaches aiming at improving CAR T cell function. As a key study, we focus on CD19-specific CAR CD8+ T cells modulated by miR-155 overexpression, but the protocol can be applied to characterize other functional immune cell modulation strategies.
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Affiliation(s)
- Dragana Slavkovic-Lukic
- Division of Functional Immune Cell Modulation, Leibniz Institute for Immunotherapy (LIT), Regensburg, Germany.
| | - Jessica Fioravanti
- Division of Functional Immune Cell Modulation, Leibniz Institute for Immunotherapy (LIT), Regensburg, Germany
| | - Azucena Martín-Santos
- Division of Functional Immune Cell Modulation, Leibniz Institute for Immunotherapy (LIT), Regensburg, Germany
| | - Edward Han
- IsoPlexis Corporation, Branford, CT, USA
| | - Jing Zhou
- IsoPlexis Corporation, Branford, CT, USA
| | - Luca Gattinoni
- Division of Functional Immune Cell Modulation, Leibniz Institute for Immunotherapy (LIT), Regensburg, Germany.
- Center for Immunomedicine in Transplantation and Oncology (CITO), University Hospital Regensburg, Regensburg, Germany.
- University of Regensburg, Regensburg, Germany.
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27
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Ruella M, Korell F, Porazzi P, Maus MV. Mechanisms of resistance to chimeric antigen receptor-T cells in haematological malignancies. Nat Rev Drug Discov 2023; 22:976-995. [PMID: 37907724 PMCID: PMC10965011 DOI: 10.1038/s41573-023-00807-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 11/02/2023]
Abstract
Chimeric antigen receptor (CAR)-T cells have recently emerged as a powerful therapeutic approach for the treatment of patients with chemotherapy-refractory or relapsed blood cancers, including acute lymphoblastic leukaemia, diffuse large B cell lymphoma, follicular lymphoma, mantle cell lymphoma and multiple myeloma. Nevertheless, resistance to CAR-T cell therapies occurs in most patients. In this Review, we summarize the resistance mechanisms to CAR-T cell immunotherapy by analysing CAR-T cell dysfunction, intrinsic tumour resistance and the immunosuppressive tumour microenvironment. We discuss current research strategies to overcome multiple resistance mechanisms, including optimization of the CAR design, improvement of in vivo T cell function and persistence, modulation of the immunosuppressive tumour microenvironment and synergistic combination strategies.
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Affiliation(s)
- Marco Ruella
- Division of Hematology and Oncology and Center for Cellular Immunotherapies, University of Pennsylvania, Philadelphia, PA, USA
| | - Felix Korell
- Cellular Immunotherapy Program, Massachusetts General Hospital Cancer Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Patrizia Porazzi
- Division of Hematology and Oncology and Center for Cellular Immunotherapies, University of Pennsylvania, Philadelphia, PA, USA
| | - Marcela V Maus
- Cellular Immunotherapy Program, Massachusetts General Hospital Cancer Center, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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28
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Zanvit P, van Dyk D, Fazenbaker C, McGlinchey K, Luo W, Pezold JM, Meekin J, Chang CY, Carrasco RA, Breen S, Cheung CSF, Endlich-Frazier A, Clark B, Chu NJ, Vantellini A, Martin PL, Hoover CE, Riley K, Sweet SM, Chain D, Kim YJ, Tu E, Harder N, Phipps S, Damschroder M, Gilbreth RN, Cobbold M, Moody G, Bosco EE. Antitumor activity of AZD0754, a dnTGFβRII-armored, STEAP2-targeted CAR-T cell therapy, in prostate cancer. J Clin Invest 2023; 133:e169655. [PMID: 37966111 PMCID: PMC10645390 DOI: 10.1172/jci169655] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/21/2023] [Indexed: 11/16/2023] Open
Abstract
Prostate cancer is generally considered an immunologically "cold" tumor type that is insensitive to immunotherapy. Targeting surface antigens on tumors through cellular therapy can induce a potent antitumor immune response to "heat up" the tumor microenvironment. However, many antigens expressed on prostate tumor cells are also found on normal tissues, potentially causing on-target, off-tumor toxicities and a suboptimal therapeutic index. Our studies revealed that six-transmembrane epithelial antigen of prostate-2 (STEAP2) was a prevalent prostate cancer antigen that displayed high, homogeneous cell surface expression across all stages of disease with limited distal normal tissue expression, making it ideal for therapeutic targeting. A multifaceted lead generation approach enabled development of an armored STEAP2 chimeric antigen receptor T cell (CAR-T) therapeutic candidate, AZD0754. This CAR-T product was armored with a dominant-negative TGF-β type II receptor, bolstering its activity in the TGF-β-rich immunosuppressive environment of prostate cancer. AZD0754 demonstrated potent and specific cytotoxicity against antigen-expressing cells in vitro despite TGF-β-rich conditions. Further, AZD0754 enforced robust, dose-dependent in vivo efficacy in STEAP2-expressing cancer cell line-derived and patient-derived xenograft mouse models, and exhibited encouraging preclinical safety. Together, these data underscore the therapeutic tractability of STEAP2 in prostate cancer as well as build confidence in the specificity, potency, and tolerability of this potentially first-in-class CAR-T therapy.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Philip L. Martin
- Oncology Translational Medicine, Oncology R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Clare E. Hoover
- Clinical Pathology Patient Safety, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Kenesha Riley
- Clinical Pathology Patient Safety, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Steve M. Sweet
- Oncology Translational Medicine, Oncology R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - David Chain
- Oncology Translational Medicine, Oncology R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Yeoun Jin Kim
- Oncology Translational Medicine, Oncology R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Eric Tu
- Oncology Translational Medicine, Oncology R&D, AstraZeneca, Gaithersburg, Maryland, USA
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29
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Hadley P, Chen Y, Cline L, Han Z, Tang Q, Huang X, Desai T. Precise surface functionalization of PLGA particles for human T cell modulation. Nat Protoc 2023; 18:3289-3321. [PMID: 37853157 PMCID: PMC10775953 DOI: 10.1038/s41596-023-00887-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/05/2023] [Indexed: 10/20/2023]
Abstract
The biofunctionalization of synthetic materials has extensive utility for biomedical applications, but approaches to bioconjugation typically show insufficient efficiency and controllability. We recently developed an approach by building synthetic DNA scaffolds on biomaterial surfaces that enables the precise control of cargo density and ratio, thus improving the assembly and organization of functional cargos. We used this approach to show that the modulation and phenotypic adaptation of immune cells can be regulated using our precisely functionalized biomaterials. Here, we describe the three key procedures, including the fabrication of polymeric particles engrafted with short DNA scaffolds, the attachment of functional cargos with complementary DNA strands, and the surface assembly control and quantification. We also explain the critical checkpoints needed to ensure the overall quality and expected characteristics of the biological product. We provide additional experimental design considerations for modifying the approach by varying the material composition, size or cargo types. As an example, we cover the use of the protocol for human primary T cell activation and for the identification of parameters that affect ex vivo T cell manufacturing. The protocol requires users with diverse expertise ranging from synthetic materials to bioconjugation chemistry to immunology. The fabrication procedures and validation assays to design high-fidelity DNA-scaffolded biomaterials typically require 8 d.
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Affiliation(s)
- Pierce Hadley
- Medical Scientist Training Program, University of California, San Francisco, CA, USA
- UC Berkeley-UCSF Graduate Program in Bioengineering, UCSF Mission Bay Campus, San Francisco, CA, USA
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
- Diabetes Center, University of California, San Francisco, CA, USA
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA
| | - Yuanzhou Chen
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
- Cell Design Institute and Center for Synthetic Immunology, University of California, San Francisco, CA, USA
| | - Lariana Cline
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | - Zhiyuan Han
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | - Qizhi Tang
- Diabetes Center, University of California, San Francisco, CA, USA
- Gladstone-UCSF Institute of Genomic Immunology, San Francisco, CA, USA
- Department of Surgery, University of California, San Francisco, CA, USA
| | - Xiao Huang
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA.
- Cell Design Institute and Center for Synthetic Immunology, University of California, San Francisco, CA, USA.
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA.
| | - Tejal Desai
- UC Berkeley-UCSF Graduate Program in Bioengineering, UCSF Mission Bay Campus, San Francisco, CA, USA.
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA.
- Diabetes Center, University of California, San Francisco, CA, USA.
- Cell Design Institute and Center for Synthetic Immunology, University of California, San Francisco, CA, USA.
- School of Engineering, Brown University, Providence, RI, USA.
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30
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Noll JH, Levine BL, June CH, Fraietta JA. Beyond youth: Understanding CAR T cell fitness in the context of immunological aging. Semin Immunol 2023; 70:101840. [PMID: 37729825 DOI: 10.1016/j.smim.2023.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
Population aging, a pervasive global demographic trend, is anticipated to challenge health and social systems worldwide. This phenomenon is due to medical advancements enabling longer lifespans, with 20% of the US population soon to be over 65 years old. Consequently, there will be a surge in age-related diseases. Senescence, characterized by the loss of biological maintenance and homeostasis at molecular and cellular levels, either correlates with or directly causes age-related phenotypic changes. Decline of the immune system is a critical factor in the senescence process, with cancer being a primary cause of death in elderly populations. Chimeric antigen receptor (CAR) T cell therapy, an innovative approach, has demonstrated success mainly in pediatric and young adult hematological malignancies but remains largely ineffective for diseases affecting older populations, such as late-in-life B cell malignancies and most solid tumor indications. This limitation arises because CAR T cell efficacy heavily relies on the fitness of the patient-derived starting T cell material. Numerous studies suggest that T cell senescence may be a key driver of CAR T cell deficiency. This review examines correlates and underlying factors associated with favorable CAR T cell outcomes and explores potential experimental and clinically actionable strategies for T cell rejuvenation.
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Affiliation(s)
- Julia Han Noll
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bruce L Levine
- Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Carl H June
- Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph A Fraietta
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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31
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Singh N, Maus MV. Synthetic manipulation of the cancer-immunity cycle: CAR-T cell therapy. Immunity 2023; 56:2296-2310. [PMID: 37820585 DOI: 10.1016/j.immuni.2023.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/15/2023] [Accepted: 09/15/2023] [Indexed: 10/13/2023]
Abstract
Synthetic immunity to cancer has been pioneered by the application of chimeric antigen receptor (CAR) engineering into autologous T cells. CAR T cell therapy is highly amenable to molecular engineering to bypass barriers of the cancer immunity cycle, such as endogenous antigen presentation, immune priming, and natural checkpoints that constrain immune responses. Here, we review CAR T cell design and the mechanisms that drive sustained CAR T cell effector activity and anti-tumor function. We discuss engineering approaches aimed at improving anti-tumor function through a variety of mechanistic interventions for both hematologic and solid tumors. The ability to engineer T cells in such a variety of ways, including by modifying their trafficking, antigen recognition, costimulation, and addition of synthetic genes, circuits, knockouts and base edits to finely tune complex functions, is arguably the most powerful way to manipulate the cancer immunity cycle in patients.
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Affiliation(s)
- Nathan Singh
- Division of Oncology, Washington University in St Louis School of Medicine, St. Louis, MO 63110, USA.
| | - Marcela V Maus
- Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA 02114, USA.
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32
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Lee HY, Yang SB, Park MY, Baek GW, Kang HJ. RE: Epigenetic profiling and response to CD19 chimeric antigen receptor T-cell therapy in B-cell malignancies. J Natl Cancer Inst 2023; 115:1231-1233. [PMID: 37594794 DOI: 10.1093/jnci/djad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023] Open
Affiliation(s)
- Hwan Young Lee
- Department of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Forensic and Anthropological Science, Seoul National University College of Medicine, Seoul, Korea
| | - Soo-Bin Yang
- Department of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Mi Young Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Seoul National University Cancer Research Institute, Seoul, Korea
| | - Gyung Won Baek
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Seoul National University Cancer Research Institute, Seoul, Korea
| | - Hyoung Jin Kang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Seoul National University Cancer Research Institute, Seoul, Korea
- Seoul National University Children's Hospital, Seoul, Korea
- Wide River Institute of Immunology, Hongcheon-gun, Gangwon-do, Korea
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33
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Wu T, Tan JHL, Sin W, Luah YH, Tan SY, Goh M, Birnbaum ME, Chen Q, Cheow LF. Cell Granularity Reflects Immune Cell Function and Enables Selection of Lymphocytes with Superior Attributes for Immunotherapy. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2302175. [PMID: 37544893 PMCID: PMC10558660 DOI: 10.1002/advs.202302175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/20/2023] [Indexed: 08/08/2023]
Abstract
In keeping with the rule of "form follows function", morphological aspects of a cell can reflect its role. Here, it is shown that the cellular granularity of a lymphocyte, represented by its intrinsic side scatter (SSC), is a potent indicator of its cell state and function. The granularity of a lymphocyte increases from naïve to terminal effector state. High-throughput cell-sorting yields a SSChigh population that can mediate immediate effector functions, and a highly prolific SSClow population that can give rise to the replenishment of the memory pool. CAR-T cells derived from the younger SSClow population possess desirable attributes for immunotherapy, manifested by increased naïve-like cells and stem cell memory (TSCM )-like cells together with a balanced CD4/CD8 ratio, as well as enhanced target-killing in vitro and in vivo. Altogether, lymphocyte segregation based on biophysical properties is an effective approach for label-free selection of cells that share collective functions and can have important applications for cell-based immunotherapies.
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Affiliation(s)
- Tongjin Wu
- Department of Biomedical EngineeringFaculty of EngineeringNational University of SingaporeSingapore117583Singapore
- Institute for Health Innovation and TechnologyNational University of SingaporeSingapore117599Singapore
| | - Joel Heng Loong Tan
- Institute of Molecular and Cell Biology (IMCB)Agency for ScienceTechnology and Research (A*STAR)Singapore138673Singapore
| | - Wei‐Xiang Sin
- Critical Analytics for Manufacturing of Personalized MedicineSingapore‐MIT Alliance for Research and TechnologySingapore138602Singapore
| | - Yen Hoon Luah
- Department of Biomedical EngineeringFaculty of EngineeringNational University of SingaporeSingapore117583Singapore
- Institute for Health Innovation and TechnologyNational University of SingaporeSingapore117599Singapore
- Critical Analytics for Manufacturing of Personalized MedicineSingapore‐MIT Alliance for Research and TechnologySingapore138602Singapore
| | - Sue Yee Tan
- Institute of Molecular and Cell Biology (IMCB)Agency for ScienceTechnology and Research (A*STAR)Singapore138673Singapore
| | - Myra Goh
- Institute of Molecular and Cell Biology (IMCB)Agency for ScienceTechnology and Research (A*STAR)Singapore138673Singapore
| | - Michael E. Birnbaum
- Critical Analytics for Manufacturing of Personalized MedicineSingapore‐MIT Alliance for Research and TechnologySingapore138602Singapore
- Department of Biological EngineeringMassachusetts Institute of TechnologyCambridgeMA02139USA
| | - Qingfeng Chen
- Institute of Molecular and Cell Biology (IMCB)Agency for ScienceTechnology and Research (A*STAR)Singapore138673Singapore
| | - Lih Feng Cheow
- Department of Biomedical EngineeringFaculty of EngineeringNational University of SingaporeSingapore117583Singapore
- Institute for Health Innovation and TechnologyNational University of SingaporeSingapore117599Singapore
- Critical Analytics for Manufacturing of Personalized MedicineSingapore‐MIT Alliance for Research and TechnologySingapore138602Singapore
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34
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Foskolou IP, Bunse L, Van den Bossche J. 2-hydroxyglutarate rides the cancer-immunity cycle. Curr Opin Biotechnol 2023; 83:102976. [PMID: 37515937 DOI: 10.1016/j.copbio.2023.102976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/04/2023] [Indexed: 07/31/2023]
Abstract
2-hydroxyglutarate (2HG) is a biproduct of the Krebs cycle, which exists in a D- and L- enantiomer and is structurally similar to α-ketoglutarate. Both 2HG enantiomers have been described to accumulate in diverse cancer and immune cells and can influence cell fate and function. While D-2HG was originally considered as an 'oncometabolite' that aberrantly builds up in certain cancers, it is becoming clear that it also physiologically accumulates in immune cells and regulates immune function. Conversely, L-2HG is considered as an 'immunometabolite' due to its induction and regulatory function in T cells, but it can also be induced in certain cancers. Here, the authors review the effects of both 2HG enantiomers on immune cells within the tumor microenvironment.
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Affiliation(s)
- Iosifina P Foskolou
- Department of Hematopoiesis, Sanquin Research and Department of Hematology University Medical Center, University of Amsterdam, the Netherlands
| | - Lukas Bunse
- German Cancer Consortium (DKTK) Clinical Cooperation Unit (CCU) Neuroimmunology and Brain Tumor Immunology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Neurology, MCTN, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; DKFZ Hector Cancer Institute at the University Medical Center Mannheim, Mannheim Germany
| | - Jan Van den Bossche
- Department of Molecular Cell Biology and Immunology, Amsterdam Cardiovascular Sciences, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Institute for Infection and Immunity, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
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Boulch M, Cazaux M, Cuffel A, Ruggiu M, Allain V, Corre B, Loe-Mie Y, Hosten B, Cisternino S, Auvity S, Thieblemont C, Caillat-Zucman S, Bousso P. A major role for CD4 + T cells in driving cytokine release syndrome during CAR T cell therapy. Cell Rep Med 2023; 4:101161. [PMID: 37595589 PMCID: PMC10518592 DOI: 10.1016/j.xcrm.2023.101161] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/21/2023] [Accepted: 07/26/2023] [Indexed: 08/20/2023]
Abstract
Anti-CD19 chimeric antigen receptor (CAR) T cell therapy represents a breakthrough for the treatment of B cell malignancies. Yet, it can lead to severe adverse events, including cytokine release syndrome (CRS), which may require urgent clinical management. Whether interpatient variability in CAR T cell subsets contributes to CRS is unclear. Here, we show that CD4+ CAR T cells are the main drivers of CRS. Using an immunocompetent model of anti-CD19 CAR T cell therapy, we report that CD4+, but not CD8+, CAR T cells elicit physiological CRS-like manifestations associated with the release of inflammatory cytokines. In CAR T cell-treated patients, CRS occurrence and severity are significantly associated with high absolute values of CD4+ CAR T cells in the blood. CRS in mice occurs independently of CAR T cell-derived interferon γ (IFN-γ) but requires elevated tumor burden. Thus, adjusting the CD4:CD8 CAR T cell ratio to patient tumor load may help mitigate CAR T cell-associated toxicities.
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Affiliation(s)
- Morgane Boulch
- Institut Pasteur, Université Paris Cité, INSERM U1223, Dynamics of Immune Responses Unit, Équipe Labellisée Ligue Contre le Cancer, 75015 Paris, France
| | - Marine Cazaux
- Institut Pasteur, Université Paris Cité, INSERM U1223, Dynamics of Immune Responses Unit, Équipe Labellisée Ligue Contre le Cancer, 75015 Paris, France
| | - Alexis Cuffel
- Université Paris Cité, Hôpital Saint-Louis, AP-HP Nord, Laboratoire d'Immunologie, Paris, France; INSERM UMR976, Institut de Recherche St-Louis, Paris, France
| | - Mathilde Ruggiu
- Institut Pasteur, Université Paris Cité, INSERM U1223, Dynamics of Immune Responses Unit, Équipe Labellisée Ligue Contre le Cancer, 75015 Paris, France
| | - Vincent Allain
- Université Paris Cité, Hôpital Saint-Louis, AP-HP Nord, Laboratoire d'Immunologie, Paris, France; INSERM UMR976, Institut de Recherche St-Louis, Paris, France
| | - Béatrice Corre
- Institut Pasteur, Université Paris Cité, INSERM U1223, Dynamics of Immune Responses Unit, Équipe Labellisée Ligue Contre le Cancer, 75015 Paris, France
| | - Yann Loe-Mie
- Institut Pasteur, Université Paris Cité, Bioinformatics and Biostatistics HUB, 75015 Paris, France
| | - Benoit Hosten
- Université Paris Cité, INSERM, UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, 75006 Paris, France; Service de Pharmacie, Unité Claude Kellershohn - Radiopharmacie R&D, AP-HP, Hôpital Saint-Louis, 75475 Paris, France
| | - Salvatore Cisternino
- Université Paris Cité, INSERM, UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, 75006 Paris, France; Service de Pharmacie, AP-HP, Hôpital Necker, 75015 Paris, France
| | - Sylvain Auvity
- Université Paris Cité, INSERM, UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, 75006 Paris, France; Service de Pharmacie, AP-HP, Hôpital Necker, 75015 Paris, France
| | - Catherine Thieblemont
- Hémato-Oncologie, Hôpital Saint-Louis, AP-HP, Université Paris Cité, Inserm U1153, Paris, France
| | - Sophie Caillat-Zucman
- Université Paris Cité, Hôpital Saint-Louis, AP-HP Nord, Laboratoire d'Immunologie, Paris, France; INSERM UMR976, Institut de Recherche St-Louis, Paris, France
| | - Philippe Bousso
- Institut Pasteur, Université Paris Cité, INSERM U1223, Dynamics of Immune Responses Unit, Équipe Labellisée Ligue Contre le Cancer, 75015 Paris, France.
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Alsajjan R, Mason WP. Bispecific T-Cell Engagers and Chimeric Antigen Receptor T-Cell Therapies in Glioblastoma: An Update. Curr Oncol 2023; 30:8501-8549. [PMID: 37754534 PMCID: PMC10529026 DOI: 10.3390/curroncol30090619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/28/2023] Open
Abstract
Glioblastoma is the most common malignant primary brain tumor in adults. The prognosis is extremely poor even with standard treatment of maximal safe resection, radiotherapy, and chemotherapy. Recurrence is inevitable within months, and treatment options are very limited. Chimeric antigen receptor T-cell therapy (CART) and bispecific T-cell engagers (TCEs) are two emerging immunotherapies that can redirect T-cells for tumor-specific killing and have shown remarkable success in hematological malignancies and been under extensive study for application in glioblastoma. While there have been multiple clinical trials showing preliminary evidence of safety and efficacy for CART, bispecific TCEs are still in the early stages of clinical testing, with preclinical studies showing very promising results. However, there are multiple shared challenges that need to be addressed in the future, including the route of delivery, antigen escape, the immunosuppressive tumor microenvironment, and toxicity resulting from the limited choice of tumor-specific antigens. Efforts are underway to optimize the design of both these treatments and find the ideal combination therapy to overcome these challenges. In this review, we describe the work that has been performed as well as novel approaches in glioblastoma and in other solid tumors that may be applicable in the future.
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Affiliation(s)
- Roa Alsajjan
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2C1, Canada
- Division of Neurology, Department of Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Warren P. Mason
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2C1, Canada
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Dickinson MJ, Barba P, Jäger U, Shah NN, Blaise D, Briones J, Shune L, Boissel N, Bondanza A, Mariconti L, Marchal AL, Quinn DS, Yang J, Price A, Sohoni A, Treanor LM, Orlando EJ, Mataraza J, Davis J, Lu D, Zhu X, Engels B, Moutouh-de Parseval L, Brogdon JL, Moschetta M, Flinn IW. A Novel Autologous CAR-T Therapy, YTB323, with Preserved T-cell Stemness Shows Enhanced CAR T-cell Efficacy in Preclinical and Early Clinical Development. Cancer Discov 2023; 13:1982-1997. [PMID: 37249512 PMCID: PMC10481129 DOI: 10.1158/2159-8290.cd-22-1276] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/21/2023] [Accepted: 05/23/2023] [Indexed: 05/31/2023]
Abstract
CAR T-cell product quality and stemness (Tstem) are major determinants of in vivo expansion, efficacy, and clinical response. Prolonged ex vivo culturing is known to deplete Tstem, affecting clinical outcome. YTB323, a novel autologous CD19-directed CAR T-cell therapy expressing the same validated CAR as tisagenlecleucel, is manufactured using a next-generation platform in <2 days. Here, we report the preclinical development and preliminary clinical data of YTB323 in adults with relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL; NCT03960840). In preclinical mouse models, YTB323 exhibited enhanced in vivo expansion and antitumor activity at lower doses than traditionally manufactured CAR T cells. Clinically, at doses 25-fold lower than tisagenlecleucel, YTB323 showed (i) promising overall safety [cytokine release syndrome (any grade, 35%; grade ≥3, 6%), neurotoxicity (any grade, 25%; grade ≥3, 6%)]; (ii) overall response rates of 75% and 80% for DL1 and DL2, respectively; (iii) comparable CAR T-cell expansion; and (iv) preservation of T-cell phenotype. Current data support the continued development of YTB323 for r/r DLBCL. SIGNIFICANCE Traditional CAR T-cell manufacturing requires extended ex vivo cell culture, reducing naive and stem cell memory T-cell populations and diminishing antitumor activity. YTB323, which expresses the same validated CAR as tisagenlecleucel, can be manufactured in <2 days while retaining T-cell stemness and enhancing clinical activity at a 25-fold lower dose. See related commentary by Wang, p. 1961. This article is featured in Selected Articles from This Issue, p. 1949.
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Affiliation(s)
- Michael J. Dickinson
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, and the Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Pere Barba
- Hematology Department, Hospital Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ulrich Jäger
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, and Comprehensive Cancer Center, Vienna General Hospital – Medical University of Vienna, Vienna, Austria
| | | | - Didier Blaise
- Département d'Hématologie, Programme de Transplantation et de Thérapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Aix-Marseille University, Institut Paoli Calmettes, Marseille, France
| | - Javier Briones
- Hematology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Leyla Shune
- University of Kansas Medical Center, Kansas City, Kansas
| | - Nicolas Boissel
- Hematology Adolescent and Young Adult Unit, Saint-Louis Hospital, APHP, Paris, France
| | | | - Luisa Mariconti
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - David S. Quinn
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Jennifer Yang
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Andrew Price
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Akash Sohoni
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Louise M. Treanor
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Elena J. Orlando
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Jennifer Mataraza
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Jaclyn Davis
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Darlene Lu
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Xu Zhu
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Boris Engels
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | | | | | | | - Ian W. Flinn
- Sarah Cannon Research Institute and Tennessee Oncology Center for Blood Cancers, Nashville, Tennessee
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Fang KKL, Lee J, Khatri I, Na Y, Zhang L. Targeting T-cell malignancies using allogeneic double-negative CD4-CAR-T cells. J Immunother Cancer 2023; 11:e007277. [PMID: 37678917 PMCID: PMC10496713 DOI: 10.1136/jitc-2023-007277] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Patients with relapsed/refractory T-cell malignancies have limited treatment options. The use of chimeric antigen receptor (CAR)-T cell therapy for T-cell malignancies is challenging due to possible blast contamination of autologous T-cell products and fratricide of CAR-T cells targeting T-lineage antigens. Recently, allogeneic double-negative T cells (DNTs) have been shown to be safe as an off-the-shelf adoptive cell therapy and to be amendable for CAR transduction. Here, we explore the antitumor activity of allogeneic DNTs against T-cell malignancies and the potential of using anti-CD4-CAR (CAR4)-DNTs as adoptive cell therapy for T-cell malignancies. METHODS Healthy donor-derived allogeneic DNTs were ex vivo expanded with or without CAR4 transduction. The antitumor activity of DNTs and CAR4-DNTs against T-cell acute lymphoblastic leukemia (T-ALL) and peripheral T-cell lymphoma (PTCL) were examined using flow cytometry-based cytotoxicity assays and xenograft models. Mechanisms of action were investigated using transwell assays and blocking assays. RESULTS Allogeneic DNTs induced endogenous antitumor cytotoxicity against T-ALL and PTCL in vitro, but high doses of DNTs were required to attain therapeutic effects in vivo. The potency of DNTs against T-cell malignancies was significantly enhanced by transducing DNTs with a third-generation CAR4. CAR4-DNTs were manufactured without fratricide and showed superior cytotoxicity against CD4+ T-ALL and PTCL in vitro and in vivo relative to empty-vector transduced-DNTs. CAR4-DNTs eliminated T-ALL and PTCL cell lines and primary T-ALL blasts in vitro. CAR4-DNTs effectively infiltrated tumors, delayed tumor progression, and prolonged the survival of T-ALL and PTCL xenografts. Further, pretreatment of CAR4-DNTs with PI3Kδ inhibitor idelalisib promoted memory phenotype of CAR4-DNTs and enhanced their persistence and antileukemic efficacy in vivo. Mechanistically, LFA-1, NKG2D, and perforin/granzyme B degranulation pathways were involved in the DNT-mediated and CAR4-DNT-mediated killing of T-ALL and PTCL. CONCLUSIONS These results demonstrate that CAR4-DNTs can effectively target T-ALL and PTCL and support allogeneic CAR4-DNTs as adoptive cell therapy for T-cell malignancies.
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Affiliation(s)
- Karen Kai-Lin Fang
- Toronto General Hospital Research Institute, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jongbok Lee
- Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Ismat Khatri
- Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Yoosu Na
- Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Li Zhang
- Toronto General Hospital Research Institute, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Immunology, University of Toronto, Toronto, Ontario, Canada
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Terao T, Kitamura W, Fujii N, Asada N, Kamoi C, Fujiwara K, Kondo K, Matsubara C, Hayashino K, Seike K, Fujiwara H, Ennishi D, Nishimori H, Fujii K, Matsuoka KI, Maeda Y. Negative Prognostic Impact of High-Dose or Long-Term Corticosteroid Use in Patients with Relapsed or Refractory B-Cell Lymphoma Who Received Tisagenlecleucel. Transplant Cell Ther 2023; 29:573.e1-573.e8. [PMID: 37394114 DOI: 10.1016/j.jtct.2023.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/04/2023]
Abstract
The prognostic impact of corticosteroid therapy in patients receiving tisagenlecleucel (tisa-cel) treatment who are more likely to develop cytokine release syndrome (CRS) remains unclear. This study aimed to evaluate the clinical impact and lymphocyte kinetics of corticosteroid administration for CRS in 45 patients with relapsed and/or refractory B-cell lymphoma treated with tisa-cel. This was a retrospective evaluation of all consecutive patients diagnosed with relapsed and/or refractory diffuse large B-cell lymphoma, follicular lymphoma with histologic transformation to large B-cell lymphoma, or follicular lymphoma who received commercial-based tisa-cel treatment. The best overall response rate, complete response rate, median progression-free survival (PFS), and median overall survival (OS) were 72.7%, 45.5%, 6.6 months, and 15.3 months, respectively. CRS (predominantly grade 1/2) occurred in 40 patients (88.9%), and immune effector cell-associated neurotoxicity syndrome (ICANS) of all grades occurred in 3 patients (6.7%). No grade ≥3 ICANS occurred. Patients with high-dose (≥524 mg, methylprednisolone equivalent; n = 12) or long-term (≥8 days; n = 9) corticosteroid use had inferior PFS and OS to patients with low-dose or no corticosteroid use (both P < .05). The prognostic impact remained even in 23 patients with stable disease (SD) or progressive disease (PD) before tisa-cel infusion (P = .015). but not in patients with better disease status (P = .71). The timing of corticosteroid initiation did not have a prognostic impact. Multivariate analysis identified high-dose corticosteroid use and long-term corticosteroid use as independent prognostic factors for PFS and OS, respectively, after adjusting for elevated lactate dehydrogenase level before lymphodepletion chemotherapy and disease status (SD or PD). Lymphocyte kinetics analysis demonstrated that after methylprednisolone administration, the proportions of regulatory T cells (Tregs), CD4+ central memory T (TCM) cells, and natural killer (NK) cells were decreased, whereas the proportion of CD4+ effector memory T (TEM) cells was increased. Patients with a higher proportion of Tregs at day 7 had a lower incidence of CRS, but this did not affect prognosis, indicating that early elevation of Tregs may serve as a biomarker for CRS development. Furthermore, patients with higher numbers of CD4+ TCM cells and NK cells at various time points had significantly better PFS and OS, whereas the number of CD4+ TEM cells did not impact prognostic outcomes. This study suggests that high-dose or long-term corticosteroid use attenuates the efficacy of tisa-cel, especially in patients with SD or PD. Additionally, patients with high levels of CD4+ TCM cells and NK cells after tisa-cel infusion had longer PFS and OS.
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Affiliation(s)
- Toshiki Terao
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan; Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Wataru Kitamura
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan; Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Nobuharu Fujii
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan; Division of Blood Transfusion, Okayama University Hospital, Okayama, Japan.
| | - Noboru Asada
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Chihiro Kamoi
- Division of Blood Transfusion, Okayama University Hospital, Okayama, Japan
| | - Kanako Fujiwara
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Kaho Kondo
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Chisato Matsubara
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Kenta Hayashino
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Keisuke Seike
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Hideaki Fujiwara
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Daisuke Ennishi
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Hisakazu Nishimori
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Keiko Fujii
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan; Division of Clinical Laboratory, Okayama University Hospital, Okayama, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan; Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Salz L, Seitz A, Schäfer D, Franzen J, Holzer T, Garcia-Prieto CA, Bürger I, Hardt O, Esteller M, Wagner W. Culture expansion of CAR T cells results in aberrant DNA methylation that is associated with adverse clinical outcome. Leukemia 2023; 37:1868-1878. [PMID: 37452103 PMCID: PMC10457202 DOI: 10.1038/s41375-023-01966-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/15/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
Chimeric antigen receptor (CAR) T cells provide new perspectives for treatment of hematological malignancies. Manufacturing of these cellular products includes culture expansion procedures, which may affect cellular integrity and therapeutic outcome. In this study, we investigated culture-associated epigenetic changes in CAR T cells and found continuous gain of DNAm, particularly within genes that are relevant for T cell function. Hypermethylation in many genes, such as TCF7, RUNX1, and TOX, was reflected by transcriptional downregulation. 332 CG dinucleotides (CpGs) showed an almost linear gain in methylation with cell culture time, albeit neighboring CpGs were not coherently regulated on the same DNA strands. An epigenetic signature based on 14 of these culture-associated CpGs predicted cell culture time across various culture conditions. Notably, even in CAR T cell products of similar culture time higher DNAm levels at these CpGs were associated with significantly reduced long-term survival post transfusion. Our data demonstrate that cell culture expansion of CAR T cells evokes DNA hypermethylation at specific sites in the genome and the signature may also reflect loss of potential in CAR T cell products. Hence, reduced cultivation periods are beneficial to avoid dysfunctional methylation programs that seem to be associated with worse therapeutic outcome.
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Affiliation(s)
- Lucia Salz
- Institute for Stem Cell Biology, RWTH Aachen University Medical School, Aachen, Germany
- Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University Medical School, Aachen, Germany
| | - Alexander Seitz
- Institute for Stem Cell Biology, RWTH Aachen University Medical School, Aachen, Germany
- Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University Medical School, Aachen, Germany
- Miltenyi Biotec B.V. & Co. KG, Bergisch, Gladbach, Germany
| | - Daniel Schäfer
- Miltenyi Biotec B.V. & Co. KG, Bergisch, Gladbach, Germany
| | - Julia Franzen
- Institute for Stem Cell Biology, RWTH Aachen University Medical School, Aachen, Germany
- Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University Medical School, Aachen, Germany
| | - Tatjana Holzer
- Miltenyi Biotec B.V. & Co. KG, Bergisch, Gladbach, Germany
| | - Carlos A Garcia-Prieto
- Josep Carreras Leukemia Research Institute (IJC), Badalona, Barcelona, Catalonia, Spain
- Life Sciences Department, Barcelona Supercomputing Center (BSC), Barcelona, Spain
| | - Iris Bürger
- Miltenyi Biotec B.V. & Co. KG, Bergisch, Gladbach, Germany
| | - Olaf Hardt
- Miltenyi Biotec B.V. & Co. KG, Bergisch, Gladbach, Germany
| | - Manel Esteller
- Josep Carreras Leukemia Research Institute (IJC), Badalona, Barcelona, Catalonia, Spain
- Life Sciences Department, Barcelona Supercomputing Center (BSC), Barcelona, Spain
- Centro de Investigacion Biomedica en Red Cancer (CIBERONC), Madrid, Spain
- Institucio Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain
- Physiological Sciences Department, School of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Catalonia, Spain
| | - Wolfgang Wagner
- Institute for Stem Cell Biology, RWTH Aachen University Medical School, Aachen, Germany.
- Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University Medical School, Aachen, Germany.
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Zawidzka EM, Biavati L, Thomas A, Zanettini C, Marchionni L, Leone R, Borrello I. Tumor-Specific CD8 + T Cells from the Bone Marrow Resist Exhaustion and Exhibit Increased Persistence in Tumor-Bearing Hosts as Compared to Tumor Infiltrating Lymphocytes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.28.555119. [PMID: 37693379 PMCID: PMC10491133 DOI: 10.1101/2023.08.28.555119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Immunotherapy is now an integral aspect of cancer therapy. Strategies employing adoptive cell therapy (ACT) have seen the establishment of chimeric antigen receptor (CAR)-T cells using peripheral blood lymphocytes as well as tumor infiltrating lymphocytes (TILs) with significant clinical results. Despite these successes, the limitations of the current strategies are also emerging and novel approaches are needed. The bone marrow (BM) is an immunological niche that houses T cells with specificity for previously encountered antigens, including tumor-associated antigens from certain solid cancers. This study sought to improve our understanding of tumor-specific BM T cells in the context of solid tumors by comparing them with TILs, and to assess whether there is a rationale for using the BM as a source of T cells for ACT against solid malignancies. Herein, we demonstrate that T cells from the BM appear superior to TILs as a source of cells for cellular therapy. Specifically, they possess a memory-enriched phenotype and exhibit improved effector function, greater persistence within a tumor-bearing host, and the capacity for increased tumor infiltration. Taken together, these data provide a foundation for further exploring the BM as a source of tumor-specific T cells for ACT in solid malignancies.
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Affiliation(s)
- Elizabeth M. Zawidzka
- Johns Hopkins University School of Medicine, Bloomberg Kimmel Institute for Cancer Immunotherapy
| | - Luca Biavati
- Johns Hopkins University School of Medicine, Bloomberg Kimmel Institute for Cancer Immunotherapy
| | - Amy Thomas
- Johns Hopkins University School of Medicine, Bloomberg Kimmel Institute for Cancer Immunotherapy
| | | | | | - Robert Leone
- Johns Hopkins University School of Medicine, Bloomberg Kimmel Institute for Cancer Immunotherapy
| | - Ivan Borrello
- Johns Hopkins University School of Medicine, Bloomberg Kimmel Institute for Cancer Immunotherapy
- Current Address: Tampa General Hospital Cancer Institute
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Yamauchi A, Yoshimoto S, Kudo A, Takagi S. Negative Influence of Aging on Differentiation and Proliferation of CD8 + T-Cells in Dogs. Vet Sci 2023; 10:541. [PMID: 37756063 PMCID: PMC10534501 DOI: 10.3390/vetsci10090541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/24/2023] [Accepted: 08/22/2023] [Indexed: 09/28/2023] Open
Abstract
Immunosenescence is an age-related change in the immune system characterized by a reduction in naïve T-cells and an impaired proliferative capacity of CD8+ T-cells in older individuals. Recent research revealed the crucial impact of immunosenescence on the development and control of cancer, and aging is one of the causes that diminish the therapeutic efficacy of cancer immunotherapies targeting CD8+ T-cell activation. Despite dog cancer being defined as an age-related disease, there are few fundamental understandings regarding the relationship between aging and the canine immune system. Therefore, we aimed to elucidate the characteristics of immunosenescence in dogs and analyzed the effects of aging on the differentiation status and proliferation of canine CD8+ T cells using T-cell specific stimulation with anti-canine CD3/CD28 antibody-coated beads and interleukin-2. As a result, we found that older dogs have a lower proliferative capacity of CD8+ T-cells and a reduction in the naïve subset in their peripheral blood. Further analysis showed that older dogs had attenuated proliferation of the effector and central memory subsets. These results indicate the importance of maintaining less differentiated subsets to expand CD8+ T-cells in dogs and provide helpful insight into the development of dog immune therapies that require T-cell expansion ex vivo.
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Affiliation(s)
- Akinori Yamauchi
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara 252-5201, Kanagawa, Japan
| | - Sho Yoshimoto
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara 252-5201, Kanagawa, Japan
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ayano Kudo
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara 252-5201, Kanagawa, Japan
| | - Satoshi Takagi
- Laboratory of Small Animal Surgery, Department of Veterinary Medicine, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara 252-5201, Kanagawa, Japan
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Rothemejer FH, Lauritsen NP, Søgaard OS, Tolstrup M. Strategies for enhancing CAR T cell expansion and persistence in HIV infection. Front Immunol 2023; 14:1253395. [PMID: 37671164 PMCID: PMC10475529 DOI: 10.3389/fimmu.2023.1253395] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/04/2023] [Indexed: 09/07/2023] Open
Abstract
Chimeric Antigen Receptor (CAR) T cell therapies are tremendously successful in hematological malignancies and show great promise as treatment and curative strategy for HIV. A major determinant for effective CAR T cell therapy is the persistence of CAR T cells. Particularly, antigen density and target cell abundance are crucial for the engagement, engraftment, and persistence of CAR T cells. The success of HIV-specific CAR T cells is challenged by limited antigen due to low cell surface expression of viral proteins and the scarcity of chronically infected cells during antiretroviral therapy. Several strategies have been explored to increase the efficacy of CAR T cells by enhancing expansion and persistence of the engineered cells. This review highlights the challenges of designing CAR T cells against HIV and other chronic viral infections. We also discuss potential strategies to enhance CAR T cell expansion and persistence in the setting of low antigen exposure.
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Affiliation(s)
- Frederik Holm Rothemejer
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Nanna Pi Lauritsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Schmeltz Søgaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Martin Tolstrup
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
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Aparicio C, Acebal C, González-Vallinas M. Current approaches to develop "off-the-shelf" chimeric antigen receptor (CAR)-T cells for cancer treatment: a systematic review. Exp Hematol Oncol 2023; 12:73. [PMID: 37605218 PMCID: PMC10440917 DOI: 10.1186/s40164-023-00435-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023] Open
Abstract
Chimeric antigen receptor (CAR)-T cell therapy is one of the most promising advances in cancer treatment. It is based on genetically modified T cells to express a CAR, which enables the recognition of the specific tumour antigen of interest. To date, CAR-T cell therapies approved for commercialisation are designed to treat haematological malignancies, showing impressive clinical efficacy in patients with relapsed or refractory advanced-stage tumours. However, since they all use the patient´s own T cells as starting material (i.e. autologous use), they have important limitations, including manufacturing delays, high production costs, difficulties in standardising the preparation process, and production failures due to patient T cell dysfunction. Therefore, many efforts are currently being devoted to contribute to the development of safe and effective therapies for allogeneic use, which should be designed to overcome the most important risks they entail: immune rejection and graft-versus-host disease (GvHD). This systematic review brings together the wide range of different approaches that have been studied to achieve the production of allogeneic CAR-T cell therapies and discuss the advantages and disadvantages of every strategy. The methods were classified in two major categories: those involving extra genetic modifications, in addition to CAR integration, and those relying on the selection of alternative cell sources/subpopulations for allogeneic CAR-T cell production (i.e. γδ T cells, induced pluripotent stem cells (iPSCs), umbilical cord blood T cells, memory T cells subpopulations, virus-specific T cells and cytokine-induced killer cells). We have observed that, although genetic modification of T cells is the most widely used approach, new approaches combining both methods have emerged. However, more preclinical and clinical research is needed to determine the most appropriate strategy to bring this promising antitumour therapy to the clinical setting.
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Affiliation(s)
- Cristina Aparicio
- Unit of Excellence Institute of Biomedicine and Molecular Genetics of Valladolid (IBGM), Universidad de Valladolid (UVa)-CSIC, Valladolid, Spain
- Department of Biochemistry, Molecular Biology and Physiology, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - Carlos Acebal
- Unit of Excellence Institute of Biomedicine and Molecular Genetics of Valladolid (IBGM), Universidad de Valladolid (UVa)-CSIC, Valladolid, Spain
- Department of Biochemistry, Molecular Biology and Physiology, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - Margarita González-Vallinas
- Unit of Excellence Institute of Biomedicine and Molecular Genetics of Valladolid (IBGM), Universidad de Valladolid (UVa)-CSIC, Valladolid, Spain.
- Department of Biochemistry, Molecular Biology and Physiology, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain.
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45
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Moreno-Cortes E, Franco-Fuquen P, Garcia-Robledo JE, Forero J, Booth N, Castro JE. ICOS and OX40 tandem co-stimulation enhances CAR T-cell cytotoxicity and promotes T-cell persistence phenotype. Front Oncol 2023; 13:1200914. [PMID: 37719008 PMCID: PMC10502212 DOI: 10.3389/fonc.2023.1200914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/02/2023] [Indexed: 09/19/2023] Open
Abstract
Chimeric Antigen Receptor (CAR) T-cell therapies have emerged as an effective and potentially curative immunotherapy for patients with relapsed or refractory malignancies. Treatment with CD19 CAR T-cells has shown unprecedented results in hematological malignancies, including heavily refractory leukemia, lymphoma, and myeloma cases. Despite these encouraging results, CAR T-cell therapy faces limitations, including the lack of long-term responses in nearly 50-70% of the treated patients and low efficacy in solid tumors. Among other reasons, these restrictions are related to the lack of targetable tumor-associated antigens, limitations on the CAR design and interactions with the tumor microenvironment (TME), as well as short-term CAR T-cell persistence. Because of these reasons, we developed and tested a chimeric antigen receptor (CAR) construct with an anti-ROR1 single-chain variable-fragment cassette connected to CD3ζ by second and third-generation intracellular signaling domains including 4-1BB, CD28/4-1BB, ICOS/4-1BB or ICOS/OX40. We observed that after several successive tumor-cell in vitro challenges, ROR1.ICOS.OX40ζ continued to proliferate, produce pro-inflammatory cytokines, and induce cytotoxicity against ROR1+ cell lines in vitro with enhanced potency. Additionally, in vivo ROR1.ICOS.OX40ζ T-cells showed anti-lymphoma activity, a long-lasting central memory phenotype, improved overall survival, and evidence of long-term CAR T-cell persistence. We conclude that anti-ROR1 CAR T-cells that are activated by ICOS.OX40 tandem co-stimulation show in vitro and in vivo enhanced targeted cytotoxicity associated with a phenotype that promotes T-cell persistence.
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Affiliation(s)
- Eider Moreno-Cortes
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United States
- Cancer Research and Cellular Therapy Laboratory, Mayo Clinic, Phoenix, AZ, United States
| | - Pedro Franco-Fuquen
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United States
- Cancer Research and Cellular Therapy Laboratory, Mayo Clinic, Phoenix, AZ, United States
| | - Juan E. Garcia-Robledo
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United States
- Cancer Research and Cellular Therapy Laboratory, Mayo Clinic, Phoenix, AZ, United States
| | - Jose Forero
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United States
- Cancer Research and Cellular Therapy Laboratory, Mayo Clinic, Phoenix, AZ, United States
- Division of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Natalie Booth
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United States
- Cancer Research and Cellular Therapy Laboratory, Mayo Clinic, Phoenix, AZ, United States
- Center for Cancer and Blood Disorders, Phoenix Children’s Hospital, Phoenix, AZ, United States
| | - Januario E. Castro
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, United States
- Cancer Research and Cellular Therapy Laboratory, Mayo Clinic, Phoenix, AZ, United States
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46
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Kapitza L, Ho N, Kerzel T, Frank AM, Thalheimer FB, Jamali A, Schaser T, Buchholz CJ, Hartmann J. CD62L as target receptor for specific gene delivery into less differentiated human T lymphocytes. Front Immunol 2023; 14:1183698. [PMID: 37646032 PMCID: PMC10461316 DOI: 10.3389/fimmu.2023.1183698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/24/2023] [Indexed: 09/01/2023] Open
Abstract
Chimeric antigen receptor (CAR)-expressing T cells are a complex and heterogeneous gene therapy product with variable phenotype compositions. A higher proportion of less differentiated CAR T cells is usually associated with improved antitumoral function and persistence. We describe in this study a novel receptor-targeted lentiviral vector (LV) named 62L-LV that preferentially transduces less differentiated T cells marked by the L-selectin receptor CD62L, with transduction rates of up to 70% of CD4+ and 50% of CD8+ primary T cells. Remarkably, higher amounts of less differentiated T cells are transduced and preserved upon long-term cultivation using 62L-LV compared to VSV-LV. Interestingly, shed CD62L neither altered the binding of 62L-LV particles to T cells nor impacted their transduction. The incubation of 2 days of activated T lymphocytes with 62L-LV or VSV-LV for only 24 hours was sufficient to generate CAR T cells that controlled tumor growth in a leukemia tumor mouse model. The data proved that potent CAR T cells can be generated by short-term ex vivo exposure of primary cells to LVs. As a first vector type that preferentially transduces less differentiated T lymphocytes, 62L-LV has the potential to circumvent cumbersome selections of T cell subtypes and offers substantial shortening of the CAR T cell manufacturing process.
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Affiliation(s)
- Laura Kapitza
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Naphang Ho
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
| | - Thomas Kerzel
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
| | - Annika M. Frank
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
| | | | - Arezoo Jamali
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
| | - Thomas Schaser
- Research & Development, Miltenyi Biotec B.V. & Co. KG, Bergisch Gladbach, Germany
| | - Christian J. Buchholz
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Frankfurt Cancer Institute, Goethe University, Frankfurt am Main, Germany
| | - Jessica Hartmann
- Molecular Biotechnology and Gene Therapy, Paul-Ehrlich-Institut, Langen, Germany
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Ling M, Cardle II, Song K, Yan AJ, Kacherovsky N, Jensen MC, Pun SH. Aptamer-Based Chromatographic Methods for Efficient and Economical Separation of Leukocyte Populations. ACS Biomater Sci Eng 2023; 9:5062-5071. [PMID: 37467493 PMCID: PMC11016351 DOI: 10.1021/acsbiomaterials.3c00651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
The manufacturing process of chimeric antigen receptor T cell therapies includes isolation systems that provide pure T cells. Current magnetic-activated cell sorting and immunoaffinity chromatography methods produce desired cells with high purity and yield but require expensive equipment and reagents and involve time-consuming incubation steps. Here, we demonstrate that aptamers can be employed in a continuous-flow resin platform for both depletion of monocytes and selection of CD8+ T cells from peripheral blood mononuclear cells at low cost with high purity and throughput. Aptamer-mediated cell selection could potentially enable fully synthetic, traceless isolations of leukocyte subsets from a single isolation system.
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Affiliation(s)
- Melissa Ling
- Molecular Engineering and Sciences Institute, University of Washington, Seattle, WA 98195
| | - Ian I. Cardle
- Department of Bioengineering, University of Washington, Seattle, WA 98195
- Seattle Children’s Therapeutics, Seattle, WA 98101
| | - Kefan Song
- Department of Bioengineering, University of Washington, Seattle, WA 98195
| | - Alexander J. Yan
- Department of Bioengineering, University of Washington, Seattle, WA 98195
| | - Nataly Kacherovsky
- Department of Bioengineering, University of Washington, Seattle, WA 98195
| | | | - Suzie H. Pun
- Molecular Engineering and Sciences Institute, University of Washington, Seattle, WA 98195
- Department of Bioengineering, University of Washington, Seattle, WA 98195
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48
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Wei W, Chen ZN, Wang K. CRISPR/Cas9: A Powerful Strategy to Improve CAR-T Cell Persistence. Int J Mol Sci 2023; 24:12317. [PMID: 37569693 PMCID: PMC10418799 DOI: 10.3390/ijms241512317] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
As an emerging treatment strategy for malignant tumors, chimeric antigen receptor T (CAR-T) cell therapy has been widely used in clinical practice, and its efficacy has been markedly improved in the past decade. However, the clinical effect of CAR-T therapy is not so satisfying, especially in solid tumors. Even in hematologic malignancies, a proportion of patients eventually relapse after receiving CAR-T cell infusions, owing to the poor expansion and persistence of CAR-T cells. Recently, CRISPR/Cas9 technology has provided an effective approach to promoting the proliferation and persistence of CAR-T cells in the body. This technology has been utilized in CAR-T cells to generate a memory phenotype, reduce exhaustion, and screen new targets to improve the anti-tumor potential. In this review, we aim to describe the major causes limiting the persistence of CAR-T cells in patients and discuss the application of CRISPR/Cas9 in promoting CAR-T cell persistence and its anti-tumor function. Finally, we investigate clinical trials for CRISPR/Cas9-engineered CAR-T cells for the treatment of cancer.
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Affiliation(s)
| | - Zhi-Nan Chen
- National Translational Science Center for Molecular Medicine & Department of Cell Biology, Fourth Military Medical University, Xi’an 710032, China;
| | - Ke Wang
- National Translational Science Center for Molecular Medicine & Department of Cell Biology, Fourth Military Medical University, Xi’an 710032, China;
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49
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Westin JR, Oluwole OO, Kersten MJ, Miklos DB, Perales MA, Ghobadi A, Rapoport AP, Sureda A, Jacobson CA, Farooq U, van Meerten T, Ulrickson M, Elsawy M, Leslie LA, Chaganti S, Dickinson M, Dorritie K, Reagan PM, McGuirk J, Song KW, Riedell PA, Minnema MC, Yang Y, Vardhanabhuti S, Filosto S, Cheng P, Shahani SA, Schupp M, To C, Locke FL. Survival with Axicabtagene Ciloleucel in Large B-Cell Lymphoma. N Engl J Med 2023; 389:148-157. [PMID: 37272527 DOI: 10.1056/nejmoa2301665] [Citation(s) in RCA: 70] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND In an analysis of the primary outcome of this phase 3 trial, patients with early relapsed or refractory large B-cell lymphoma who received axicabtagene ciloleucel (axi-cel), an autologous anti-CD19 chimeric antigen receptor T-cell therapy, as second-line treatment had significantly longer event-free survival than those who received standard care. Data were needed on longer-term outcomes. METHODS In this trial, we randomly assigned patients with early relapsed or refractory large B-cell lymphoma in a 1:1 ratio to receive either axi-cel or standard care (two to three cycles of chemoimmunotherapy followed by high-dose chemotherapy with autologous stem-cell transplantation in patients who had a response). The primary outcome was event-free survival, and key secondary outcomes were response and overall survival. Here, we report the results of the prespecified overall survival analysis at 5 years after the first patient underwent randomization. RESULTS A total of 359 patients underwent randomization to receive axi-cel (180 patients) or standard care (179 patients). At a median follow-up of 47.2 months, death had been reported in 82 patients in the axi-cel group and in 95 patients in the standard-care group. The median overall survival was not reached in the axi-cel group and was 31.1 months in the standard-care group; the estimated 4-year overall survival was 54.6% and 46.0%, respectively (hazard ratio for death, 0.73; 95% confidence interval [CI], 0.54 to 0.98; P = 0.03 by stratified two-sided log-rank test). This increased survival with axi-cel was observed in the intention-to-treat population, which included 74% of patients with primary refractory disease and other high-risk features. The median investigator-assessed progression-free survival was 14.7 months in the axi-cel group and 3.7 months in the standard-care group, with estimated 4-year percentages of 41.8% and 24.4%, respectively (hazard ratio, 0.51; 95% CI, 0.38 to 0.67). No new treatment-related deaths had occurred since the primary analysis of event-free survival. CONCLUSIONS At a median follow-up of 47.2 months, axi-cel as second-line treatment for patients with early relapsed or refractory large B-cell lymphoma resulted in significantly longer overall survival than standard care. (Funded by Kite; ZUMA-7 ClinicalTrials.gov number, NCT03391466.).
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Affiliation(s)
- Jason R Westin
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Olalekan O Oluwole
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Marie José Kersten
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - David B Miklos
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Miguel-Angel Perales
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Armin Ghobadi
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Aaron P Rapoport
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Anna Sureda
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Caron A Jacobson
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Umar Farooq
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Tom van Meerten
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Matthew Ulrickson
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Mahmoud Elsawy
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Lori A Leslie
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Sridhar Chaganti
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Michael Dickinson
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Kathleen Dorritie
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Patrick M Reagan
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Joseph McGuirk
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Kevin W Song
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Peter A Riedell
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Monique C Minnema
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Yin Yang
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Saran Vardhanabhuti
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Simone Filosto
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Paul Cheng
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Shilpa A Shahani
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Marco Schupp
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Christina To
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
| | - Frederick L Locke
- From University of Texas M.D. Anderson Cancer Center, Houston (J.R.W.); Vanderbilt-Ingram Cancer Center, Nashville (O.O.O.); Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam (M.J.K.), UMC Groningen, Groningen (T.M.), and UMC Utrecht, Utrecht (M.C.M.) - all in the Netherlands; Stanford University School of Medicine, Stanford (D.B.M.), and Kite, Santa Monica (Y.Y., S.V., S.F., P.C., S.A.S., M.S., C.T.) - both in California; Memorial Sloan Kettering Cancer Center, New York (M.-A.P.), and University of Rochester School of Medicine, Rochester (P.M.R.) - both in New York; Washington University School of Medicine, St. Louis (A.G.); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore (A.P.R.); Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospitalet, Institut de Recerca Biomèdica de Bellvitge, Universitat de Barcelona, Barcelona (A.S.B.); Dana-Farber Cancer Institute, Boston (C.A.J.); University of Iowa, Iowa City (U.F.); Banner M.D. Anderson Cancer Center, Gilbert, AZ (M.U.); the Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS (M.E.), and Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver (K.W.S.) - both in Canada; John Theurer Cancer Center, Hackensack, NJ (L.A.L.); the Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (S.C.); Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and the University of Melbourne, Melbourne (M.D.); UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh (K.D.); University of Kansas Cancer Center, Kansas City (J.M.); David and Etta Jonas Center for Cellular Therapy, University of Chicago, Chicago (P.A.R.); and Moffitt Cancer Center, Tampa, FL (F.L.L.)
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Yu T, Luo C, Zhang H, Tan Y, Yu L. Cord blood-derived CD19-specific chimeric antigen receptor T cells: an off-the-shelf promising therapeutic option for treatment of diffuse large B-cell lymphoma. Front Immunol 2023; 14:1139482. [PMID: 37449207 PMCID: PMC10338183 DOI: 10.3389/fimmu.2023.1139482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/26/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose Autologous chimeric antigen receptor (CAR) T cell therapy is one of the most significant breakthroughs in hematological malignancies. However, a three-week manufacturing cycle and ineffective T cell dysfunction in some patients hinder the widespread application of auto-CAR T cell therapy. Studies suggest that cord blood (CB), with its unique biological properties, could be an optimal source for CAR T cells, providing a product with 'off-the-shelf' availability. Therefore, exploring the potential of CB as an immunotherapeutic agent is essential for understanding and promoting the further use of CAR T cell therapy. Experimental design We used CB to generate CB-derived CD19-targeting CAR T (CB CD19-CAR T) cells. We assessed the anti-tumor capacity of CB CD19-CAR T cells to kill diffuse large B cell lymphoma (DLBCL) in vitro and in vivo. Results CB CD19-CAR T cells showed the target-specific killing of CD19+ T cell lymphoma cell line BV173 and CD19+ DLBCL cell line SUDHL-4, activated various effector functions, and inhibited tumor progression in a mouse (BALB/c nude) model. However, some exhaustion-associated genes were involved in off-tumor cytotoxicity towards activated lymphocytes. Gene expression profiles confirmed increased chemokines/chemokine receptors and exhaustion genes in CB CD19-CAR T cells upon tumor stimulation compared to CB T cells. They indicated inherent changes in the associated signaling pathways in the constructed CB CAR T cells and targeted tumor processes. Conclusion CB CD19-CAR T cells represent a promising therapeutic strategy for treating DLBCL. The unique biological properties and high availability of CB CD19-CAR T cells make this approach feasible.
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Affiliation(s)
- Tiantian Yu
- Department of Hematology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Division of Hematopathology and Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Cancan Luo
- Department of Hematology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huihui Zhang
- R&D Department, Qilu Cell Therapy Technology Co., Ltd., Jinan, Shandong, China
| | - Yi Tan
- R&D Department, Qilu Cell Therapy Technology Co., Ltd., Jinan, Shandong, China
| | - Li Yu
- Department of Hematology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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