1
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Appelbaum J, Price AE, Oda K, Zhang J, Leung WH, Tampella G, Xia D, So PP, Hilton SK, Evandy C, Sarkar S, Martin U, Krostag AR, Leonardi M, Zak DE, Logan R, Lewis P, Franke-Welch S, Ngwenyama N, Fitzgerald M, Tulberg N, Rawlings-Rhea S, Gardner RA, Jones K, Sanabria A, Crago W, Timmer J, Hollands A, Eckelman B, Bilic S, Woodworth J, Lamble A, Gregory PD, Jarjour J, Pogson M, Gustafson JA, Astrakhan A, Jensen MC. Drug-regulated CD33-targeted CAR T cells control AML using clinically optimized rapamycin dosing. J Clin Invest 2024:e162593. [PMID: 38502193 DOI: 10.1172/jci162593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Chimeric antigen receptor (CAR) designs that incorporate pharmacologic control are desirable, however designs suitable for clinical translation are needed. We designed a fully human, rapamycin-regulated, drug product for targeting CD33+ tumors called dimerization agent regulated immunoreceptor complex (DARIC33). T cell products demonstrated target specific and rapamycin-dependent cytokine release, transcriptional responses, cytotoxicity, and in vivo antileukemic activity in the presence of as little as 1nM rapamycin. Rapamycin withdrawal paused DARIC33-stimulated T cell effector functions, which were restored following re-exposure to rapamycin, demonstrating reversible effector function control. While rapamycin-regulated DARIC33 T cells were highly sensitive to target antigen, CD34+ stem cell colony forming capacity was not impacted. We benchmarked DARIC33 potency relative to CD19 CAR T cells to estimate a T cell dose for clinical testing. In addition, we integrated in vitro and preclinical in vivo drug concentration thresholds for OFF-ON state transitions, as well as murine and human rapamycin pharmacokinetics, to estimate a clinically applicable rapamycin dosing schedule. A phase 1 DARIC33 trial has been initiated (PLAT-08, NCT05105152), with initial evidence of rapamycin-regulated T cell activation and anti-tumor impact. Our findings provide evidence that the DARIC platform exhibits sensitive regulation and potency needed for clinical application to other important immunotherapy targets.
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Affiliation(s)
- Jacob Appelbaum
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | | | - Kaori Oda
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | - Joy Zhang
- 2seventy bio, Cambridge, United States of America
| | | | - Giacomo Tampella
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | - Dong Xia
- 2seventy bio, Cambridge, United States of America
| | | | | | - Claudya Evandy
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | - Semanti Sarkar
- Seattle Children's Therapeutics, Seattle Children`s Research Institute, Seattle, United States of America
| | - Unja Martin
- 2seventy bio, Cambridge, United States of America
| | | | - Marissa Leonardi
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | - Daniel E Zak
- 2seventy bio, Cambridge, United States of America
| | - Rachael Logan
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | - Paula Lewis
- 2seventy bio, Cambridge, United States of America
| | | | | | - Michael Fitzgerald
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | - Niklas Tulberg
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | - Stephanie Rawlings-Rhea
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | - Rebecca A Gardner
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | - Kyle Jones
- Inhibrx, La Jolla, United States of America
| | | | | | | | | | | | - Sanela Bilic
- Vanadro Consulting, Urbandale, United States of America
| | - Jim Woodworth
- Vanadro Consulting, Urbandale, United States of America
| | - Adam Lamble
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | | | | | - Mark Pogson
- 2seventy bio, Cambridge, United States of America
| | - Joshua A Gustafson
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
| | | | - Michael C Jensen
- Seattle Children's Therapeutics, Seattle Children's Research Institute, Seattle, United States of America
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2
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Ritmeester-Loy SA, Draper IH, Bueter EC, Lautz JD, Zhang-Wong Y, Gustafson JA, Wilson AL, Lin C, Gafken PR, Jensen MC, Orentas R, Smith SEP. Differential protein-protein interactions underlie signaling mediated by the TCR and a 4-1BB domain-containing CAR. Sci Signal 2024; 17:eadd4671. [PMID: 38442200 PMCID: PMC10986860 DOI: 10.1126/scisignal.add4671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 01/09/2024] [Indexed: 03/07/2024]
Abstract
Cells rely on activity-dependent protein-protein interactions to convey biological signals. For chimeric antigen receptor (CAR) T cells containing a 4-1BB costimulatory domain, receptor engagement is thought to stimulate the formation of protein complexes similar to those stimulated by T cell receptor (TCR)-mediated signaling, but the number and type of protein interaction-mediating binding domains differ between CARs and TCRs. Here, we performed coimmunoprecipitation mass spectrometry analysis of a second-generation, CD19-directed 4-1BB:ζ CAR (referred to as bbζCAR) and identified 128 proteins that increased their coassociation after target engagement. We compared activity-induced TCR and CAR signalosomes by quantitative multiplex coimmunoprecipitation and showed that bbζCAR engagement led to the activation of two modules of protein interactions, one similar to TCR signaling that was more weakly engaged by bbζCAR as compared with the TCR and one composed of TRAF signaling complexes that was not engaged by the TCR. Batch-to-batch and interindividual variations in production of the cytokine IL-2 correlated with differences in the magnitude of protein network activation. Future CAR T cell manufacturing protocols could measure, and eventually control, biological variation by monitoring these signalosome activation markers.
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Affiliation(s)
- Samuel A. Ritmeester-Loy
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Isabella H. Draper
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Eric C. Bueter
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Jonathan D Lautz
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Yue Zhang-Wong
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Joshua A. Gustafson
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
- Seattle Children’s Therapeutics, Seattle Children’s Research Institute, Seattle, WA 98101 USA
| | - Ashley L. Wilson
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
- Seattle Children’s Therapeutics, Seattle Children’s Research Institute, Seattle, WA 98101 USA
| | - Chenwei Lin
- Proteomics and Metabolomics Facility, Fred Hutchinson Cancer Center, Seattle, WA 98101, USA
| | - Philip R. Gafken
- Proteomics and Metabolomics Facility, Fred Hutchinson Cancer Center, Seattle, WA 98101, USA
| | - Michael C. Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
- Seattle Children’s Therapeutics, Seattle Children’s Research Institute, Seattle, WA 98101 USA
- Department of Pediatrics, University of Washington, Seattle, WA 98101, USA
| | - Rimas Orentas
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
- Department of Pediatrics, University of Washington, Seattle, WA 98101, USA
| | - Stephen E. P. Smith
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
- Department of Pediatrics, University of Washington, Seattle, WA 98101, USA
- Graduate Program in Neuroscience, University of Washington, Seattle, WA 98101, USA
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3
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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4
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Masih KE, Gardner RA, Chou HC, Abdelmaksoud A, Song YK, Mariani L, Gangalapudi V, Gryder BE, Wilson AL, Adebola SO, Stanton BZ, Wang C, Milewski D, Kim YY, Tian M, Cheuk ATC, Wen X, Zhang Y, Altan-Bonnet G, Kelly MC, Wei JS, Bulyk ML, Jensen MC, Orentas RJ, Khan J. A stem cell epigenome is associated with primary nonresponse to CD19 CAR T cells in pediatric acute lymphoblastic leukemia. Blood Adv 2023; 7:4218-4232. [PMID: 36607839 PMCID: PMC10440404 DOI: 10.1182/bloodadvances.2022008977] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/07/2023] Open
Abstract
CD19 chimeric antigen receptor T-cell therapy (CD19-CAR) has changed the treatment landscape and outcomes for patients with pre-B-cell acute lymphoblastic leukemia (B-ALL). Unfortunately, primary nonresponse (PNR), sustained CD19+ disease, and concurrent expansion of CD19-CAR occur in 20% of the patients and is associated with adverse outcomes. Although some failures may be attributable to CD19 loss, mechanisms of CD19-independent, leukemia-intrinsic resistance to CD19-CAR remain poorly understood. We hypothesize that PNR leukemias are distinct compared with primary sensitive (PS) leukemias and that these differences are present before treatment. We used a multiomic approach to investigate this in 14 patients (7 with PNR and 7 with PS) enrolled in the PLAT-02 trial at Seattle Children's Hospital. Long-read PacBio sequencing helped identify 1 PNR in which 47% of CD19 transcripts had exon 2 skipping, but other samples lacked CD19 transcript abnormalities. Epigenetic profiling discovered DNA hypermethylation at genes targeted by polycomb repressive complex 2 (PRC2) in embryonic stem cells. Similarly, assays of transposase-accessible chromatin-sequencing revealed reduced accessibility at these PRC2 target genes, with a gain in accessibility of regions characteristic of hematopoietic stem cells and multilineage progenitors in PNR. Single-cell RNA sequencing and cytometry by time of flight analyses identified leukemic subpopulations expressing multilineage markers and decreased antigen presentation in PNR. We thus describe the association of a stem cell epigenome with primary resistance to CD19-CAR therapy. Future trials incorporating these biomarkers, with the addition of multispecific CAR T cells targeting against leukemic stem cell or myeloid antigens, and/or combined epigenetic therapy to disrupt this distinct stem cell epigenome may improve outcomes of patients with B-ALL.
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Affiliation(s)
- Katherine E. Masih
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
- Cancer Research United Kingdom Cambridge Institute, University of Cambridge, Cambridge, England
- Medical Scientist Training Program, University of Miami Leonard M. Miller School of Medicine, Miami, FL
| | - Rebecca A. Gardner
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
- Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA
| | - Hsien-Chao Chou
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Abdalla Abdelmaksoud
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
- Advanced Biomedical Computational Science, Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Young K. Song
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Luca Mariani
- Division of Genetics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Vineela Gangalapudi
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Berkley E. Gryder
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH
| | - Ashley L. Wilson
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA
| | - Serifat O. Adebola
- Immunodynamics Group, Cancer and Inflammation Program, Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Benjamin Z. Stanton
- Center for Childhood Cancer and Blood Diseases, Nationwide Children’s Hospital, Columbus, OH
| | - Chaoyu Wang
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - David Milewski
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Yong Yean Kim
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Meijie Tian
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Adam Tai-Chi Cheuk
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Xinyu Wen
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Yue Zhang
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA
| | - Grégoire Altan-Bonnet
- Immunodynamics Group, Cancer and Inflammation Program, Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Michael C. Kelly
- Center for Cancer Research Single Cell Analysis Facility, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research, Bethesda, MD
| | - Jun S. Wei
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Martha L. Bulyk
- Division of Genetics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Michael C. Jensen
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Rimas J. Orentas
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA
| | - Javed Khan
- Oncogenomics Section, Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
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5
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Vitanza NA, Wilson AL, Huang W, Seidel K, Brown C, Gustafson JA, Yokoyama JK, Johnson AJ, Baxter BA, Koning RW, Reid AN, Meechan M, Biery MC, Myers C, Rawlings-Rhea SD, Albert CM, Browd SR, Hauptman JS, Lee A, Ojemann JG, Berens ME, Dun MD, Foster JB, Crotty EE, Leary SE, Cole BL, Perez FA, Wright JN, Orentas RJ, Chour T, Newell EW, Whiteaker JR, Zhao L, Paulovich AG, Pinto N, Gust J, Gardner RA, Jensen MC, Park JR. Intraventricular B7-H3 CAR T Cells for Diffuse Intrinsic Pontine Glioma: Preliminary First-in-Human Bioactivity and Safety. Cancer Discov 2023; 13:114-131. [PMID: 36259971 PMCID: PMC9827115 DOI: 10.1158/2159-8290.cd-22-0750] [Citation(s) in RCA: 58] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/13/2022] [Accepted: 10/13/2022] [Indexed: 01/16/2023]
Abstract
Diffuse intrinsic pontine glioma (DIPG) remains a fatal brainstem tumor demanding innovative therapies. As B7-H3 (CD276) is expressed on central nervous system (CNS) tumors, we designed B7-H3-specific chimeric antigen receptor (CAR) T cells, confirmed their preclinical efficacy, and opened BrainChild-03 (NCT04185038), a first-in-human phase I trial administering repeated locoregional B7-H3 CAR T cells to children with recurrent/refractory CNS tumors and DIPG. Here, we report the results of the first three evaluable patients with DIPG (including two who enrolled after progression), who received 40 infusions with no dose-limiting toxicities. One patient had sustained clinical and radiographic improvement through 12 months on study. Patients exhibited correlative evidence of local immune activation and persistent cerebrospinal fluid (CSF) B7-H3 CAR T cells. Targeted mass spectrometry of CSF biospecimens revealed modulation of B7-H3 and critical immune analytes (CD14, CD163, CSF-1, CXCL13, and VCAM-1). Our data suggest the feasibility of repeated intracranial B7-H3 CAR T-cell dosing and that intracranial delivery may induce local immune activation. SIGNIFICANCE This is the first report of repeatedly dosed intracranial B7-H3 CAR T cells for patients with DIPG and includes preliminary tolerability, the detection of CAR T cells in the CSF, CSF cytokine elevations supporting locoregional immune activation, and the feasibility of serial mass spectrometry from both serum and CSF. This article is highlighted in the In This Issue feature, p. 1.
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Affiliation(s)
- Nicholas A. Vitanza
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington.,Corresponding Author: Nicholas A. Vitanza, Seattle Children's Research Institute, M/S JMB-8, 1900 9th Avenue, Seattle, WA 98101. Phone: 206-884-4084; E-mail:
| | | | - Wenjun Huang
- Seattle Children's Therapeutics, Seattle, Washington
| | - Kristy Seidel
- Seattle Children's Therapeutics, Seattle, Washington
| | - Christopher Brown
- Seattle Children's Therapeutics, Seattle, Washington.,Therapeutic Cell Production Core, Seattle Children's Research Institute, Seattle, Washington
| | | | | | | | | | | | | | - Michael Meechan
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Matthew C. Biery
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Carrie Myers
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | | | - Catherine M. Albert
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington
| | - Samuel R. Browd
- Division of Neurosurgery, Seattle Children's Hospital and Department of Neurological Surgery, University of Washington, Seattle, Washington
| | - Jason S. Hauptman
- Division of Neurosurgery, Seattle Children's Hospital and Department of Neurological Surgery, University of Washington, Seattle, Washington
| | - Amy Lee
- Division of Neurosurgery, Seattle Children's Hospital and Department of Neurological Surgery, University of Washington, Seattle, Washington
| | - Jeffrey G. Ojemann
- Division of Neurosurgery, Seattle Children's Hospital and Department of Neurological Surgery, University of Washington, Seattle, Washington
| | - Michael E. Berens
- Cancer and Cell Biology Division, The Translational Genomics Research Institute (TGen), Phoenix, Arizona
| | - Matthew D. Dun
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, Callaghan, Australia.,Precision Medicine Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Jessica B. Foster
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Erin E. Crotty
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington
| | - Sarah E.S. Leary
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington
| | - Bonnie L. Cole
- Department of Laboratories, Seattle Children's Hospital, Seattle, Washington.,Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington
| | - Francisco A. Perez
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington
| | - Jason N. Wright
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington
| | - Rimas J. Orentas
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington
| | - Tony Chour
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington.,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Evan W. Newell
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, Washington.,Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Lei Zhao
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Amanda G. Paulovich
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Navin Pinto
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington
| | - Juliane Gust
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington.,Division of Pediatric Neurology, Department of Neurology, University of Washington, Seattle, Washington
| | - Rebecca A. Gardner
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington.,Seattle Children's Therapeutics, Seattle, Washington
| | | | - Julie R. Park
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington.,Seattle Children's Therapeutics, Seattle, Washington
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6
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Vitanza NA, Ronsley R, Choe M, Henson C, Breedt M, Barrios-Anderson A, Wein A, Brown C, Beebe A, Kong A, Kirkey D, Lee BM, Leary SE, Crotty EE, Hoeppner C, Holtzclaw S, Wilson AL, Gustafson JA, Foster JB, Iliff JJ, Goldstein HE, Browd SR, Lee A, Ojemann JG, Pinto N, Gust J, Gardner RA, Jensen MC, Hauptman JS, Park JR. Locoregional CAR T cells for children with CNS tumors: Clinical procedure and catheter safety. Neoplasia 2023; 36:100870. [PMID: 36599192 PMCID: PMC9823206 DOI: 10.1016/j.neo.2022.100870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 01/04/2023] Open
Abstract
Central nervous system (CNS) tumors are the most common solid malignancy in the pediatric population. Based on adoptive cellular therapy's clinical success against childhood leukemia and the preclinical efficacy against pediatric CNS tumors, chimeric antigen receptor (CAR) T cells offer hope of improving outcomes for recurrent tumors and universally fatal diseases such as diffuse intrinsic pontine glioma (DIPG). However, a major obstacle for tumors of the brain and spine is ineffective T cell chemotaxis to disease sites. Locoregional CAR T cell delivery via infusion through an intracranial catheter is currently under study in multiple early phase clinical trials. Here, we describe the Seattle Children's single-institution experience including the multidisciplinary process for the preparation of successful, repetitive intracranial T cell infusion for children and the catheter-related safety of our 307 intracranial CAR T cell doses.
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Affiliation(s)
- Nicholas A. Vitanza
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA,Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA,Corresponding author at: Seattle Children's Research Institute, M/S JMB-8, 1900 9th Avenue, Seattle, WA 98101, USA.
| | - Rebecca Ronsley
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA,Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Michelle Choe
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA,Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Casey Henson
- Division of Neurosurgery, Seattle Children's Hospital & Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Mandy Breedt
- Division of Neurosurgery, Seattle Children's Hospital & Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Adriel Barrios-Anderson
- Division of Neurosurgery, Seattle Children's Hospital & Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Amy Wein
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Christopher Brown
- Seattle Children's Therapeutics, Seattle, WA, USA,Therapeutic Cell Production Core, Seattle Children's Research Institute, Seattle, WA, USA
| | - Adam Beebe
- Seattle Children's Therapeutics, Seattle, WA, USA,Therapeutic Cell Production Core, Seattle Children's Research Institute, Seattle, WA, USA
| | - Ada Kong
- Department of Pharmacy, Seattle Children's Hospital, Seattle, WA, USA
| | - Danielle Kirkey
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA,Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Brittany M. Lee
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Sarah E.S. Leary
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA,Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Erin E. Crotty
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA,Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Corrine Hoeppner
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Susan Holtzclaw
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | | | | | - Jessica B. Foster
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jeffrey J. Iliff
- VISN 20 Mental Illness Research, Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA,Division of Pediatric Neurology, Department of Neurology, University of Washington, Seattle, WA, USA
| | - Hannah E. Goldstein
- Division of Neurosurgery, Seattle Children's Hospital & Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Samuel R. Browd
- Division of Neurosurgery, Seattle Children's Hospital & Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Amy Lee
- Division of Neurosurgery, Seattle Children's Hospital & Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Jeffrey G. Ojemann
- Division of Neurosurgery, Seattle Children's Hospital & Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Navin Pinto
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Juliane Gust
- Division of Pediatric Neurology, Department of Neurology, University of Washington, Seattle, WA, USA,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Rebecca A. Gardner
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA,Seattle Children's Therapeutics, Seattle, WA, USA
| | | | - Jason S. Hauptman
- Division of Neurosurgery, Seattle Children's Hospital & Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Julie R. Park
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA,Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA,Seattle Children's Therapeutics, Seattle, WA, USA
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7
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Bolivar-Wagers S, Loschi ML, Jin S, Thangavelu G, Larson JH, McDonald-Hyman CS, Aguilar EG, Saha A, Koehn BH, Hefazi M, Osborn MJ, Jensen MC, Wagner JE, Pennell CA, Blazar BR. Murine CAR19 Tregs suppress acute graft-versus-host disease and maintain graft-versus-tumor responses. JCI Insight 2022; 7:e160674. [PMID: 35917188 PMCID: PMC9536261 DOI: 10.1172/jci.insight.160674] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/21/2022] [Indexed: 02/03/2023] Open
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) efficacy is complicated by graft-versus-host disease (GVHD), a leading cause of morbidity and mortality. Regulatory T cells (Tregs) have shown efficacy in preventing GVHD. However, high Treg doses are often required, necessitating substantial ex vivo or in vivo expansion that may diminish suppressor function. To enhance in vivo suppressor function, murine Tregs were transduced to express an anti-human CD19 chimeric antigen receptor (hCAR19) and infused into lethally irradiated, hCD19-transgenic recipients for allo-HSCT. Compared with recipients receiving control transduced Tregs, those receiving hCAR19 Tregs had a marked decrease in acute GVHD lethality. Recipient hCD19 B cells and murine hCD19 TBL12-luciferase (TBL12luc) lymphoma cells were both cleared by allogeneic hCAR19 Tregs, which was indicative of graft-versus-tumor (GVT) maintenance and potentiation. Mechanistically, hCAR19 Tregs killed syngeneic hCD19+ but not hCD19- murine TBL12luc cells in vitro in a perforin-dependent, granzyme B-independent manner. Importantly, cyclophosphamide-treated, hCD19-transgenic mice given hCAR19 cytotoxic T lymphocytes without allo-HSCT experienced rapid lethality due to systemic toxicity that has been associated with proinflammatory cytokine release; in contrast, hCAR19 Treg suppressor function enabled avoidance of this severe complication. In conclusion, hCAR19 Tregs are a potentially novel and effective strategy to suppress GVHD without loss of GVT responses.
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Affiliation(s)
- Sara Bolivar-Wagers
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
| | - Michael L. Loschi
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
| | - Sujeong Jin
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
| | - Govindarajan Thangavelu
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
| | - Jemma H. Larson
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
| | - Cameron S. McDonald-Hyman
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ethan G. Aguilar
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
| | - Asim Saha
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
| | - Brent H. Koehn
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
| | - Mehrdad Hefazi
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark J. Osborn
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
| | - Michael C. Jensen
- Department of Pediatrics, Division of Hematology and Oncology, University of Washington, Seattle, Washington, USA
| | - John E. Wagner
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
| | - Christopher A. Pennell
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Bruce R. Blazar
- Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation & Cellular Therapy, and
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8
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Cheng EL, Cardle II, Kacherovsky N, Bansia H, Wang T, Zhou Y, Raman J, Yen A, Gutierrez D, Salipante SJ, des Georges A, Jensen MC, Pun SH. Discovery of a Transferrin Receptor 1-Binding Aptamer and Its Application in Cancer Cell Depletion for Adoptive T-Cell Therapy Manufacturing. J Am Chem Soc 2022; 144:13851-13864. [PMID: 35875870 PMCID: PMC10024945 DOI: 10.1021/jacs.2c05349] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The clinical manufacturing of chimeric antigen receptor (CAR) T cells includes cell selection, activation, gene transduction, and expansion. While the method of T-cell selection varies across companies, current methods do not actively eliminate the cancer cells in the patient's apheresis product from the healthy immune cells. Alarmingly, it has been found that transduction of a single leukemic B cell with the CAR gene can confer resistance to CAR T-cell therapy and lead to treatment failure. In this study, we report the identification of a novel high-affinity DNA aptamer, termed tJBA8.1, that binds transferrin receptor 1 (TfR1), a receptor broadly upregulated by cancer cells. Using competition assays, high resolution cryo-EM, and de novo model building of the aptamer into the resulting electron density, we reveal that tJBA8.1 shares a binding site on TfR1 with holo-transferrin, the natural ligand of TfR1. We use tJBA8.1 to effectively deplete B lymphoma cells spiked into peripheral blood mononuclear cells with minimal impact on the healthy immune cell composition. Lastly, we present opportunities for affinity improvement of tJBA8.1. As TfR1 expression is broadly upregulated in many cancers, including difficult-to-treat T-cell leukemias and lymphomas, our work provides a facile, universal, and inexpensive approach for comprehensively removing cancerous cells from patient apheresis products for safe manufacturing of adoptive T-cell therapies.
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Affiliation(s)
- Emmeline L Cheng
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, United States
| | - Ian I Cardle
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, United States.,Seattle Children's Therapeutics, Seattle, Washington 98101, United States
| | - Nataly Kacherovsky
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, United States
| | - Harsh Bansia
- Structural Biology Initiative, CUNY Advanced Science Research Center, City University of New York, New York, New York 10031, United States
| | - Tong Wang
- Nanoscience Initiative, CUNY Advanced Science Research Center, City University of New York, New York, New York 10031, United States
| | - Yunshi Zhou
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, United States
| | - Jai Raman
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, United States
| | - Albert Yen
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, United States
| | - Dominique Gutierrez
- Structural Biology Initiative, CUNY Advanced Science Research Center, City University of New York, New York, New York 10031, United States.,Ph.D. Program in Biochemistry, The Graduate Center of the City University of New York (CUNY), New York, New York 10016, United States
| | - Stephen J Salipante
- Department of Laboratory Medicine, University of Washington, Seattle, Washington 98195-7110, United States
| | - Amédée des Georges
- Structural Biology Initiative, CUNY Advanced Science Research Center, City University of New York, New York, New York 10031, United States.,Ph.D. Programs in Biochemistry and Chemistry, The Graduate Center of the City University of New York, New York, New York 10016, United States.,Department of Chemistry and Biochemistry, City College of New York, New York, New York 10031, United States
| | - Michael C Jensen
- Seattle Children's Therapeutics, Seattle, Washington 98101, United States.,Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, United States
| | - Suzie H Pun
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, United States
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9
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Sullivan PM, Kumar R, Li W, Hoglund V, Wang L, Zhang Y, Shi M, Baek D, Cheuk A, Jensen MC, Khan J, Dimitrov DS, Orentas RJ. FGFR4-targeted chimeric antigen receptors (CARs) combined with anti-myeloid poly-pharmacy effectively treats orthotopic rhabdomyosarcoma. Mol Cancer Ther 2022; 21:1608-1621. [PMID: 35877472 DOI: 10.1158/1535-7163.mct-22-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/27/2022] [Accepted: 07/20/2022] [Indexed: 11/16/2022]
Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue cancer in children. Treatment outcomes, particularly for relapsed/refractory or metastatic disease, have not improved in decades. The current lack of novel therapies and low tumor mutational burden suggest that CAR T therapy could be a promising approach to treating RMS. Previous work identified Fibroblast Growth Factor Receptor 4 (FGFR4, CD334) as being specifically upregulated in RMS, making it a candidate target for CAR-T cells. We tested the feasibility of an FGFR4 targeted CAR for treating RMS using an NSG mouse with RH30 orthotopic (intramuscular) tumors. The first barrier we noted was that RMS tumors produce a collagen-rich stroma, replete with immunosuppressive myeloid cells, when T cell therapy is initiated. This stromal response is not seen in tumor-only xenografts. When scFV-based binders were selected from phage display, CARs targeting FGFR4 were not effective until our screening approach was refined to identify binders to the membrane-proximal domain of FGFR4. Having improved the CAR, we devised a pharmacologic strategy to augment CAR-T activity by inhibiting the myeloid component of the T cell-induced tumor stroma. The combined treatment of mice with anti-myeloid polypharmacy (targeting CSF1R, IDO1, iNOS, TGFbeta, PDL1, MIF and myeloid mis-differentiation) allowed FGFR4 CAR-T to successfully clear orthotopic RMS tumors, demonstrating that RMS tumors, even with very low copy number targets, can be targeted by CAR-T upon reversal of an immunosuppressive microenvironment.
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Affiliation(s)
- Peter M Sullivan
- Seattle Children's Research Institute, Seattle, WA, United States
| | - Rajesh Kumar
- Seattle Children's Hospital's Research Instittue, Seattle, WA, United States
| | - Wei Li
- University of Pittsburgh Medical School, Pittsburgh, PA, United States
| | - Virginia Hoglund
- Seattle Children's Research Institute, Seattle, WA, United States
| | - Lingyang Wang
- Seattle Children's Research Institute, Seattle, WA, United States
| | - Yue Zhang
- Seattle Children's Research Instittue, Seattle, WA, United States
| | - Megan Shi
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Dusan Baek
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Adam Cheuk
- National Cancer Institute, Gaithersburg, MD, United States
| | | | - Javed Khan
- National Cancer Institute, Bethesda, MD, United States
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10
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Ceppi F, Wilson AL, Annesley C, Kimmerly GR, Summers C, Brand A, Seidel K, Wu QV, Beebe A, Brown C, Mgebroff S, Lindgren C, Rawlings-Rhea SD, Huang W, Pulsipher MA, Wayne AS, Park JR, Jensen MC, Gardner RA. Modified Manufacturing Process Modulates CD19CAR T-cell Engraftment Fitness and Leukemia-Free Survival in Pediatric and Young Adult Subjects. Cancer Immunol Res 2022; 10:856-870. [PMID: 35580141 PMCID: PMC9250626 DOI: 10.1158/2326-6066.cir-21-0501] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/29/2021] [Accepted: 05/12/2022] [Indexed: 01/26/2023]
Abstract
T cells modified to express a chimeric antigen receptor (CAR) targeting CD19 can induce potent and sustained responses in children with relapsed/refractory acute lymphoblastic leukemia (ALL). The durability of remission is related to the length of time the CAR T cells persist. Efforts to understand differences in persistence have focused on the CAR construct, in particular the costimulatory signaling module of the chimeric receptor. We previously reported a robust intent-to-treat product manufacturing success rate and remission induction rate in children and young adults with recurrent/refractory B-ALL using the SCRI-CAR19v1 product, a second-generation CD19-specific CAR with 4-1BB costimulation coexpressed with the EGFRt cell-surface tag (NCT02028455). Following completion of the phase I study, two changes to CAR T-cell manufacturing were introduced: switching the T-cell activation reagent and omitting midculture EGFRt immunomagnetic selection. We tested the modified manufacturing process and resulting product, designated SCRI-CAR19v2, in a cohort of 21 subjects on the phase II arm of the trial. Here, we describe the unanticipated enhancement in product performance resulting in prolonged persistence and B-cell aplasia and improved leukemia-free survival with SCRI-CAR19v2 as compared with SCRI-CAR19v1.
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Affiliation(s)
- Francesco Ceppi
- Research Division, Seattle Children's Hospital, Seattle, Washington
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, University Hospital of Lausanne, Lausanne, Switzerland
| | - Ashley L Wilson
- Research Division, Seattle Children's Hospital, Seattle, Washington
| | - Colleen Annesley
- Research Division, Seattle Children's Hospital, Seattle, Washington
- University of Washington, Department of Pediatrics, Seattle, Washington
| | | | - Corinne Summers
- Research Division, Seattle Children's Hospital, Seattle, Washington
- University of Washington, Department of Pediatrics, Seattle, Washington
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Adam Brand
- Research Division, Seattle Children's Hospital, Seattle, Washington
| | - Kristy Seidel
- Research Division, Seattle Children's Hospital, Seattle, Washington
| | - Qian Vicky Wu
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Adam Beebe
- Research Division, Seattle Children's Hospital, Seattle, Washington
| | | | | | | | | | - Wenjun Huang
- Research Division, Seattle Children's Hospital, Seattle, Washington
| | - Michael A Pulsipher
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Alan S Wayne
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Julie R Park
- Research Division, Seattle Children's Hospital, Seattle, Washington
- University of Washington, Department of Pediatrics, Seattle, Washington
| | - Michael C Jensen
- Research Division, Seattle Children's Hospital, Seattle, Washington
- University of Washington, Department of Pediatrics, Seattle, Washington
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Rebecca A Gardner
- Research Division, Seattle Children's Hospital, Seattle, Washington
- University of Washington, Department of Pediatrics, Seattle, Washington
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11
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Masih KE, Gardner R, Chou HC, Abdelmaksoud A, Song YK, Mariani L, Gangalapudi V, Gryder BE, Wilson A, Adebola SO, Stanton BZ, Wang C, Wen X, Altan-Bonnet G, Kelly MC, Wei JS, Bulyk ML, Jensen MC, Orentas RJ, Khan J. Abstract 3581: Multi-omic analysis identifies mechanisms of resistance to CD19 CAR T-cell therapy in children with acute lymphoblastic leukemia. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Despite the survival rate of 90% for newly diagnosed children with ALL, the outcome for relapsed patients is historically poor with a less than 30% survival. CD19 CAR T-cell therapy (CART19) has shown remarkable response rates, between 80-90% in relapsed/refractory disease. Little is known about antigen-independent factors that predict initial resistance to CART19. We hypothesized that leukemias that are resistant to CART19 are distinct from sensitive leukemias and that these differences can be detected prior to therapy.
Methods: To interrogate differences between resistant and sensitive leukemias, we obtained pre-treatment bone marrow aspirates (BMAs) from patients enrolled in a clinical trial at Seattle Children’s Hospital (PLAT-02). Samples were categorized based on patient response, with non-response defined as not achieving and maintaining minimal residual disease negativity at Day +63. Our study included 7 resistant and 7 sensitive leukemias as controls. We performed whole exome sequencing, bulk RNA-seq, PacBio-seq of the CD19 locus, array-based methylation, ATAC-seq, scRNA-seq, and CyTOF.
Results: We found that non-response to CART19 is independent of leukemic subtype. Despite blasts being CD19+ in all patients by flow cytometry, we identified alternative splicing of CD19 in one non-responder, while the remaining non-responders expressed high levels of wildtype CD19. We discovered a distinctive DNA methylation pattern in the non-responders characterized by hypermethylation of PRC2 targets in embryonic and cancer stem cells (p = 8.15E-25) Furthermore, using gene set enrichment analysis of ATAC-seq data, we found increased accessibility of chromatin at regions associated with stem cell proliferation (NES = 2.31; p < 0.0001) and cell cycling (NES = 2.27; p < 0.0001). We found a greater similarity between accessibility patterns of non-responders to hematopoietic progenitors, including hematopoietic stem cells (p = 0.037) and common myeloid progenitors (p = 0.047). These findings were supported by an increased frequency of cell subpopulations expressing a multi-lineage phenotype (CD19, CD20, CD33, CD34; p = 0.009). Moreover, we find decreased expression of antigen presentation and processing pathways across all leukemic cells relative to responders (p = 0.0001).
Conclusions: This study, one of the most comprehensive multi-omic analyses of samples from patients treated with CAR T-cells, identified resistance mechanisms that can be detected prior to treatment. We report the novel association of a stem cell phenotype, lineage plasticity, and decreased antigen presentation with resistance. These results support further refinement of eligibility for CART19 for children with leukemia and highlights the need for alternative of complimentary approaches for these patients.
Citation Format: Katherine E. Masih, Rebecca Gardner, Hsien-Chao Chou, Abdalla Abdelmaksoud, Young K. Song, Luca Mariani, Vineela Gangalapudi, Berkley E. Gryder, Ashley Wilson, Serifat O. Adebola, Benjamin Z. Stanton, Chaoyu Wang, Xinyu Wen, Gregoire Altan-Bonnet, Michael C. Kelly, Jun S. Wei, Martha L. Bulyk, Michael C. Jensen, Rimas J. Orentas, Javed Khan. Multi-omic analysis identifies mechanisms of resistance to CD19 CAR T-cell therapy in children with acute lymphoblastic leukemia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3581.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Xinyu Wen
- 1National Cancer Institute, Bethesda, MD
| | | | | | - Jun S. Wei
- 1National Cancer Institute, Bethesda, MD
| | | | | | | | - Javed Khan
- 1National Cancer Institute, Bethesda, MD
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12
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Zhang S, Black RG, Kohli K, Hayes BJ, Miller C, Koehne A, Schroeder BA, Abrams K, Schulte BC, Alexiev BA, Heimberger AB, Zhang A, Jing W, Ng JCK, Shinglot H, Seguin B, Salter AI, Riddell SR, Jensen MC, Gottschalk S, Moore PF, Torok-Storb B, Pollack SM. B7-H3 Specific CAR T Cells for the Naturally Occurring, Spontaneous Canine Sarcoma Model. Mol Cancer Ther 2022; 21:999-1009. [PMID: 35405743 PMCID: PMC9381119 DOI: 10.1158/1535-7163.mct-21-0726] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 01/31/2022] [Accepted: 03/31/2022] [Indexed: 01/07/2023]
Abstract
One obstacle for human solid tumor immunotherapy research is the lack of clinically relevant animal models. In this study, we sought to establish a chimeric antigen receptor (CAR) T-cell treatment model for naturally occurring canine sarcomas as a model for human CAR T-cell therapy. Canine CARs specific for B7-H3 were constructed using a single-chain variable fragment derived from the human B7-H3-specific antibody MGA271, which we confirmed to be cross-reactive with canine B7-H3. After refining activation, transduction, and expansion methods, we confirmed target killing in a tumor spheroid three-dimensional assay. We designed a B7-H3 canine CAR T-cell and achieved consistently high levels of transduction efficacy, expansion, and in vitro tumor killing. Safety of the CAR T cells were confirmed in two purposely bred healthy canine subjects following lymphodepletion by cyclophosphamide and fludarabine. Immune response, clinical parameters, and manifestation were closely monitored after treatments and were shown to resemble that of humans. No severe adverse events were observed. In summary, we demonstrated that similar to human cancers, B7-H3 can serve as a target for canine solid tumors. We successfully generated highly functional canine B7-H3-specific CAR T-cell products using a production protocol that closely models human CAR T-cell production procedure. The treatment regimen that we designed was confirmed to be safe in vivo. Our research provides a promising direction to establish in vitro and in vivo models for immunotherapy for canine and human solid tumor treatment.
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Affiliation(s)
- Shihong Zhang
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - R. Graeme Black
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Karan Kohli
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Brian J. Hayes
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Cassandra Miller
- Comparative Medicine, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Amanda Koehne
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Brett A. Schroeder
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.,NCI, NIH, Bethesda, Maryland
| | - Kraig Abrams
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Brian C. Schulte
- Department of Medicine, University of California San Francisco, San Francisco, California
| | | | - Amy B. Heimberger
- Department of Neurologic Surgery, Northwestern University, Chicago, Illinois
| | - Ali Zhang
- Department of Medicine, Northwestern University, Chicago, Illinois
| | - Weiqing Jing
- Department of Medicine, Northwestern University, Chicago, Illinois
| | | | - Himaly Shinglot
- Department of Medicine, Northwestern University, Chicago, Illinois
| | - Bernard Seguin
- Colorado State University, Flint Animal Cancer Center, Fort Collins, Colorado
| | - Alexander I. Salter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Stanley R. Riddell
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Lyell Immunopharma, Seattle, Washington
| | - Michael C. Jensen
- Division of Hematology and Oncology, Seattle Children's Hospital, Seattle, Washington
| | - Stephen Gottschalk
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Peter F. Moore
- Department of Veterinary Medicine, University of California Davis, Davis, California
| | - Beverly Torok-Storb
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Seth M. Pollack
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Department of Medicine, Northwestern University, Chicago, Illinois.,Corresponding Author: Seth M. Pollack, Oncology, Northwestern University, 303 E. Superior St. #3-115, Chicago, IL 60611. E-mail:
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13
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Albert CM, Pinto NR, Taylor M, Wilson A, Rawlings-Rhea S, Mgebroff S, Brown C, Lindgren C, Huang W, Seidel K, Narayanaswany P, Wu V, Rudzinski ER, Vitanza NA, Gust J, Gardner RA, Jensen MC, Park JR. STRIvE-01: Phase I study of EGFR806 CAR T-cell immunotherapy for recurrent/refractory solid tumors in children and young adults. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.2541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2541 Background: The epidermal growth factor receptor (EGFR) is a cell surface tyrosine kinase receptor associated with cell proliferation and differentiation. EGFR expression and activating mutations are associated with aggressive neoplastic disease, chemotherapy resistance, and increased metastatic potential. Published data and EGFR immunohistochemistry (IHC) performed on tissue microarrays indicate that 15-40% of pediatric solid tumors (ST) express EGFR. The unique EGFR monoclonal antibody (mAb) 806 selectively binds to an epitope that is conformationally hidden when EGFR is tethered but revealed when tethering is perturbed as occurs with EGFR overexpression, truncation, or through extra-cellular domain missense mutations. Methods: Children and young adults (CYA) with EGFR-expressing recurrent/refractory (R/R) ST were enrolled on a Phase 1 trial to examine the safety and feasibility of administering autologous chimeric antigen receptor (CAR) T cells derived from autologous T cells genetically modified to express a second generation EGFR806-specific scFV-IgG4hinge-CD28tm/cyto-4-1-BB-zeta and EGFRt tracking/suicide contract. All subjects received lymphodepleting chemotherapy with fludarabine and cyclophosphamide prior to the administration of cryopreserved CAR T cells a the prescribed dose level. The biologically effective dose (BED) or maximum tolerated dose was determined based upon observed toxicity through day 28 from initial CAR-T infusion and using a 3+3 statistical design. Results: Eleven subjects (n=10 evaluable, age range 9-25, median 18) were enrolled and received either dose level (DL) 1 (0.5 x 106 CAR-T/kg, n=4) or DL2 (1 x 106 CAR-T cells/kg, n=7). CAR T were manufactured successfully in all subjects. Most common toxicities were fatigue, tumor-related pain and cytokine release syndrome (n=2, maximum CTCAE grade 1). Dose limiting toxicity of CTCAE grade 4 transaminase level and hyperbilirubinemia occurred at DL2 (n=1). Maximum circulating CAR-T expansion was 29.66 cells/uL (range 0.05-29.66 cells/uL) with median persistence of 28 days (range 0-90). Two subjects on DL1 and one subject on DL2 demonstrated mixed response on day 28 and tolerated additional CAR T infusion without dose limiting toxicity. Conclusions: EGFR806 directed CAR-T cells have an acceptable toxicity profile in CYA with R/RST and demonstrate anti-tumor activity in some patients. Additional analyses are ongoing to identify biomarkers of response and toxicity. Clinical trial information: NCT03618381.
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Affiliation(s)
| | | | - Mallory Taylor
- Center for Clinical and Translationsal Research, Seattle Children’s Research Institute, Seattle, WA
| | | | | | | | | | | | - Wenjun Huang
- Seattle Children's Research Institute, Seattle, WA
| | | | | | - Vicky Wu
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Nicholas A. Vitanza
- Division of Pediatric Oncology, Hematology, Bone Marrow Transplant, and Cellular Therapy, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA
| | | | | | | | - Julie R. Park
- Seattle Children's Hospital, Cancer and Blood Disorders Center, Seattle, WA
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14
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Cooper TM, Wu V, Wilson A, Appelbaum J, Jarjour J, Gustafson J, Mgebroff S, Lindgren C, Brown C, Jensen MC, Park JR, Gardner RA. Pediatric and young adult leukemia adoptive therapy (PLAT)-08: A phase 1 study of SC-DARIC33 in pediatric and young adults with relapsed or refractory CD33+ AML. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.tps7078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS7078 Background: The acute and late effects of acute myeloid leukemia (AML) therapy in children can be devastating, and relapse rates remain high. Targeted therapies are needed to decrease toxicity and improve cure rates. Most AML patients express CD33 on their leukemic blasts. CD33 is a viable target with CD33 targeted therapies approved for AML. CD33 targeted CAR T cell therapies are being developed, but safety and efficacy remain a challenge. Safety concerns include cytokine release syndrome, neurotoxicity and aplasia. Efficacy is limited, with antigen escape and T cell exhaustion proposed as mechanisms of treatment failure. Dimerizing Agent Regulated ImmunoReceptor Complex (DARIC) is a next-generation technology that utilizes a split receptor design separating the antigen binding and intracellular signaling subunits (Leung, 2019). These subunits remain inactive until the administration of rapamycin which allows for dimerization of the subunits, enabling T cell activation when antigen is present. Modulating CAR T cell activation may aid hematopoietic recovery, enhance CAR T cell function and persistence, and mitigate toxicity. We developed a DARIC T cell product, SC-DARIC33, that couples the DARIC technology with a lentiviral construct that incorporates the use of a novel humanized camelid nanobody for targeting the C2 splice isoform within the membrane proximal domain of CD33. Methods: Up to 18 patients will be enrolled in this phase 1 study (NCT05105152). Patients must have early first relapse of AML (≤ 6 months from diagnosis), first relapse refractory to at least one reinduction attempt, second or greater relapse, or refractory de novo AML. The first 3 patients must be ≥18 years, all patients who meet eligibility criteria must be ≤28 years. The primary objectives of this Phase I study (NCT05105152) are assessment of safety/toxicity and feasibility of manufacturing of SC-DARIC33. Secondary objectives include assessment of efficacy, on/off rate of DARIC expression, engraftment, expansion and persistence of SC-DARIC33. Also, the effect of cessation of rapamycin on activation state of SC-DARIC 33 and on hematopoietic recovery will be evaluated. Subjects receive lymphodepletion prior to a single dose of SC-DARIC33 T cells on Day 0 followed by initiation of rapamycin on Day +2 with the purpose of activating the T cells. Rapamycin continues until Day 21 and bone marrow evaluation occurs on Day 28. Subsequent cycles of rapamycin are allowed for patients who respond. The trial will implement a BOIN design with three possible dose levels (1 x 106, 5 x 106, and 10 x 106 DARIC+ cells/kg) to determine the maximum tolerated dose (MTD). The trial is open for enrollment at Seattle Children’s Hospital. Clinical trial information: NCT05105152.
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Affiliation(s)
| | - Vicky Wu
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | | | | | | | | | | | | | - Julie R. Park
- Seattle Children's Hospital, Cancer and Blood Disorders Center, Seattle, WA
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15
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Pinto NR, Albert CM, Taylor M, Wilson A, Rawlings-Rhea S, Huang W, Seidel K, Narayanaswany P, Wu V, Brown C, Vitanza NA, Orentas R, Gardner RA, Jensen MC, Park JR. STRIVE-02: A first-in-human phase 1 trial of systemic B7H3 CAR T cells for children and young adults with relapsed/refractory solid tumors. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.10011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10011 Background: B7H3 (CD276) has limited expression in normal tissues and high cell-surface expression in pediatric solid malignancies providing rationale for immunologic therapeutic targeting. We present a first-in-human experience of B7H3 chimeric antigen receptor T cells (CAR-T) for children and young adults (CYA) with relapsed or refractory solid tumors (R/RST). Methods: CYA patients with R/RST were enrolled onto a Phase 1 trial (NCT04483778) to examine the safety of autologous T cells genetically modified to express scFV-IgG4hinge-CD28tm-4-1BB-zeta B7H3-specific CAR with the methotrexate resistance/selection cassette DHFRdm and the tracking/suicide construct EGFRt. All patients received lymphodepleting fludarabine and cyclophosphamide prior to infusion of cryopreserved CAR-T at the prescribed dose level. The maximal tolerated dose or biologically effective dose (BED) was determined based upon observed toxicity through day 28 from initial CAR-T infusion and using a 3+3 statistical design. Results: Sixteen subjects (age 11-24, median 17 years) enrolled and received dose level (DL) 1 (0.5 x 106 CAR-T/kg, n = 3) or DL2 (1 x 106 CAR-T cells/kg, n = 6). No dose limiting toxicity was observed following first infusion, most common toxicities were fatigue and cytokine release syndrome (CRS) (n = 2, maximum CTCAE grade 2). Maximum circulating CAR-T expansion on first infusion was 4.98 cells/uL (range 0.23-4.98 cells/uL) with median persistence of 28 days (range 14-90). Best overall response of Stable Disease was observed in 3 of the 9 subjects infused. Given observed expansion and persistence, DL2 was determined to be the BED. A second infusion at DL2 in one subject demonstrated CAR T expansion to 1590 cells/uL (86% of circulating CD3 cells) with CTCAE grade 2 CRS and transient dose limiting CTCAE grade 4 liver enzyme elevation. A partial metabolic response on FDG-PET by PERCIST criteria was observed in this subject at Day 28. Conclusions: B7H3 CAR T cells are safe and demonstrate anti-tumor activity in CYA with R/RST. CAR-T cell expansion and persistence may be necessary to achieve objective responses. STRIvE-02 Arm B will explore dual expression of CD19 CAR with B7H3 CAR, using lymphocytic CD19 expression to drive CAR expansion and persistence. Clinical trial information: NCT04483778.
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Affiliation(s)
| | | | - Mallory Taylor
- Center for Clinical and Translationsal Research, Seattle Children’s Research Institute, Seattle, WA
| | | | | | - Wenjun Huang
- Seattle Children's Research Institute, Seattle, WA
| | | | | | - Vicky Wu
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Nicholas A. Vitanza
- Division of Pediatric Oncology, Hematology, Bone Marrow Transplant, and Cellular Therapy, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA
| | | | | | | | - Julie R. Park
- Seattle Children's Hospital, Cancer and Blood Disorders Center, Seattle, WA
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16
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López CL, Brempelis KJ, Matthaei JF, Montgomery KS, Srinivasan S, Roy D, Huang F, Kreuser SA, Gardell JL, Blumenthal I, Chiefari J, Jensen MC, Crane CA, Stayton PS. Arming Immune Cell Therapeutics with Polymeric Prodrugs. Adv Healthc Mater 2022; 11:e2101944. [PMID: 34889072 PMCID: PMC9847575 DOI: 10.1002/adhm.202101944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/16/2021] [Indexed: 01/21/2023]
Abstract
Engineered immune cells are an exciting therapeutic modality, which survey and attack tumors. Backpacking strategies exploit cell targeting capabilities for delivery of drugs to combat tumors and their immune-suppressive environments. Here, a new platform for arming cell therapeutics through dual receptor and polymeric prodrug engineering is developed. Macrophage and T cell therapeutics are engineered to express a bioorthogonal single chain variable fragment receptor. The receptor binds a fluorescein ligand that directs cell loading with ligand-tagged polymeric prodrugs, termed "drugamers." The fluorescein ligand facilitates stable binding of drugamer to engineered macrophages over 10 days with 80% surface retention. Drugamers also incorporate prodrug monomers of the phosphoinositide-3-kinase inhibitor, PI-103. The extended release of PI-103 from the drugamer sustains antiproliferative activity against a glioblastoma cell line compared to the parent drug. The versatility and modularity of this cell arming system is demonstrated by loading T cells with a second fluorescein-drugamer. This drugamer incorporates a small molecule estrogen analog, CMP8, which stabilizes a degron-tagged transgene to provide temporal regulation of protein activity in engineered T cells. These results demonstrate that this bioorthogonal receptor and drugamer system can be used to arm multiple immune cell classes with both antitumor and transgene-activating small molecule prodrugs.
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Affiliation(s)
- Ciana L López
- Department of Bioengineering, University of Washington, Seattle WA 98195, USA,Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Katherine J Brempelis
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - James F Matthaei
- Seattle Children’s Therapeutics, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Kate S Montgomery
- Department of Bioengineering, University of Washington, Seattle WA 98195, USA
| | - Selvi Srinivasan
- Department of Bioengineering, University of Washington, Seattle WA 98195, USA
| | - Debashish Roy
- Department of Bioengineering, University of Washington, Seattle WA 98195, USA
| | - Fei Huang
- CSIRO Manufacturing, Bag 10, Bayview Avenue, Clayton, VIC. 3168, Australia
| | - Shannon A Kreuser
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Jennifer L Gardell
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Ian Blumenthal
- Department of Bioengineering, University of Washington, Seattle WA 98195, USA,Seattle Children’s Therapeutics, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - John Chiefari
- CSIRO Manufacturing, Bag 10, Bayview Avenue, Clayton, VIC. 3168, Australia
| | - Michael C Jensen
- Department of Bioengineering, University of Washington, Seattle WA 98195, USA,Seattle Children’s Therapeutics, Seattle Children’s Research Institute, Seattle, WA 98101, USA,Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Courtney A Crane
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA,Department of Neurological Surgery, University of Washington, Seattle WA 98195, USA
| | - Patrick S Stayton
- Department of Bioengineering, University of Washington, Seattle WA 98195, USA
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17
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Brown CE, Rodriguez A, Palmer J, Ostberg JR, Naranjo A, Wagner JR, Aguilar B, Starr R, Weng L, Synold TW, Tran V, Wang S, Reik A, D’Apuzzo M, Ressler JA, Zhou Y, Mendel M, Gregory PD, Holmes MC, Tang WW, Forman SJ, Jensen MC, Badie B. Off-the-shelf, steroid-resistant, IL13Rα2-specific CAR T cells for treatment of glioblastoma. Neuro Oncol 2022; 24:1318-1330. [PMID: 35100373 PMCID: PMC9340633 DOI: 10.1093/neuonc/noac024] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Wide-spread application of chimeric antigen receptor (CAR) T cell therapy for cancer is limited by the current use of autologous CAR T cells necessitating the manufacture of individualized therapeutic products for each patient. To address this challenge, we have generated an off-the-shelf, allogeneic CAR T cell product for the treatment of glioblastoma (GBM), and present here the feasibility, safety, and therapeutic potential of this approach. METHODS We generated for clinical use a healthy-donor derived IL13Rα2-targeted CAR+ (IL13-zetakine+) cytolytic T-lymphocyte (CTL) product genetically engineered using zinc finger nucleases (ZFNs) to permanently disrupt the glucocorticoid receptor (GR) (GRm13Z40-2) and endow resistance to glucocorticoid treatment. In a phase I safety and feasibility trial we evaluated these allogeneic GRm13Z40-2 T cells in combination with intracranial administration of recombinant human IL-2 (rhIL-2; aldesleukin) in six patients with unresectable recurrent GBM that were maintained on systemic dexamethasone (4-12 mg/day). RESULTS The GRm13Z40-2 product displayed dexamethasone-resistant effector activity without evidence for in vitro alloreactivity. Intracranial administration of GRm13Z40-2 in four doses of 108 cells over a two-week period with aldesleukin (9 infusions ranging from 2500-5000 IU) was well tolerated, with indications of transient tumor reduction and/or tumor necrosis at the site of T cell infusion in four of the six treated research subjects. Antibody reactivity against GRm13Z40-2 cells was detected in the serum of only one of the four tested subjects. CONCLUSIONS This first-in-human experience establishes a foundation for future adoptive therapy studies using off-the-shelf, zinc-finger modified, and/or glucocorticoid resistant CAR T cells.
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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, California, USA
| | - Analiz Rodriguez
- Department of Neurosurgery, City of Hope Beckman Research Institute and Medical Center; Duarte, California, USA
| | - Joycelynne Palmer
- Department of Computational and Quantitative Medicine, City of Hope Beckman Research Institute and Medical Center; Duarte, California, USA
| | - Julie R Ostberg
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center; Duarte, California, USA
| | - Araceli Naranjo
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center; Duarte, California, 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, California, USA
| | - Brenda Aguilar
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center; Duarte, California, USA
| | - Renate Starr
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center; Duarte, California, USA
| | - Lihong Weng
- Department of Hematology & Hematopoietic Cell Transplantation (T Cell Therapeutics Research Laboratories), City of Hope Beckman Research Institute and Medical Center; Duarte, California, USA
| | - Timothy W Synold
- Department of Cancer Biology, City of Hope Beckman Research Institute and Medical Center; Duarte, California, USA
| | - Vivi Tran
- Department of Cancer Biology, City of Hope Beckman Research Institute and Medical Center; Duarte, California, USA
| | - Shelley Wang
- Sangamo Therapeutics, Inc., Richmond, California, USA
| | - Andreas Reik
- Sangamo Therapeutics, Inc., Richmond, California, USA
| | - Massimo D’Apuzzo
- Department of Pathology, City of Hope Beckman Research Institute and Medical Center; Duarte, California, USA
| | - Julie A Ressler
- Department of Diagnostic Radiology, City of Hope Beckman Research Institute and Medical Center; Duarte, California, USA
| | - Yuanyue Zhou
- Sangamo Therapeutics, Inc., Richmond, California, USA
| | | | | | | | - Winson W Tang
- Sangamo Therapeutics, Inc., Richmond, California, 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, California, USA
| | - Michael C Jensen
- Ben Town Center for Childhood Cancer, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Behnam Badie
- Corresponding Author: Behnam Badie, MD, City of Hope Beckman Research Institute and Medical Center, 1500 East Duarte Rd., Rm 1201 Pavilion Bldg., Duarte, CA, USA ()
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18
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Summers C, Wu QV, Annesley C, Bleakley M, Dahlberg A, Narayanaswamy P, Huang W, Voutsinas J, Brand A, Leisenring W, Jensen MC, Park JR, Gardner RA. Hematopoietic Cell Transplantation after CD19 Chimeric Antigen Receptor T Cell-Induced Acute Lymphoblastic Lymphoma Remission Confers a Leukemia-Free Survival Advantage. Transplant Cell Ther 2021; 28:21-29. [PMID: 34644605 DOI: 10.1016/j.jtct.2021.10.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/16/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022]
Abstract
Consolidative hematopoietic cell transplantation (HCT) after CD19 chimeric antigen receptor (CAR) T cell therapy is frequently performed for patients with refractory/ relapsed B cell acute lymphoblastic leukemia (B-ALL). However, there is controversy regarding the role of HCT following remission attainment. We evaluated the effect of consolidative HCT on leukemia-free survival (LFS) in pediatric and young adult subjects following CD19 CAR T cell induced remission. We evaluated the effect of consolidative HCT on LFS in pediatric and young adult subjects treated with a 41BB-CD19 CAR T cell product on a phase 1/2 trial, Pediatric and Young Adult Leukemia Adoptive Therapy (PLAT)-02 (ClinicalTrials.gov identifier NCT02028455), using a time-dependent Cox proportional hazards statistical model. Fifty of 64 subjects enrolled in PLAT-02 phase 1 and early phase 2 were evaluated, excluding 14 subjects who did not achieve remission, relapsed, or died before day 63 post-CAR T cell therapy. An improved LFS (P = .01) was observed in subjects who underwent consolidative HCT after CAR T cell therapy versus watchful waiting. Consolidative HCT improved LFS specifically in subjects who had no prior history of HCT, with a trend toward significance (P = .09). This benefit was not evident when restricted to the cohort of 34 subjects with a history of prior HCT (P = .45). However, for subjects who had CAR T cell functional persistence of 63 days or less, inclusive of those with a history of prior HCT, HCT significantly improved LFS outcomes (P = .01). These data support the use of consolidative HCT following CD19 CAR T cell-induced remission for patients with no prior history of HCT and those with short functional CAR T cell persistence.
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Affiliation(s)
- Corinne Summers
- Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington; Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Qian Vicky Wu
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Colleen Annesley
- Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington
| | - Marie Bleakley
- Department of Pediatrics, University of Washington, Seattle, Washington; Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ann Dahlberg
- Department of Pediatrics, University of Washington, Seattle, Washington; Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Wenjun Huang
- Seattle Children's Research Institute, Seattle, Washington
| | | | - Adam Brand
- Seattle Children's Research Institute, Seattle, Washington
| | | | - Michael C Jensen
- Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington; Department of Bioengineering, University of Washington, Seattle, Washington
| | - Julie R Park
- Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington
| | - Rebecca A Gardner
- Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington.
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19
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Vitanza NA, Johnson AJ, Wilson AL, Brown C, Yokoyama JK, Künkele A, Chang CA, Rawlings-Rhea S, Huang W, Seidel K, Albert CM, Pinto N, Gust J, Finn LS, Ojemann JG, Wright J, Orentas RJ, Baldwin M, Gardner RA, Jensen MC, Park JR. Locoregional infusion of HER2-specific CAR T cells in children and young adults with recurrent or refractory CNS tumors: an interim analysis. Nat Med 2021; 27:1544-1552. [PMID: 34253928 DOI: 10.1038/s41591-021-01404-8] [Citation(s) in RCA: 121] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/25/2021] [Indexed: 12/13/2022]
Abstract
Locoregional delivery of chimeric antigen receptor (CAR) T cells has resulted in objective responses in adults with glioblastoma, but the feasibility and tolerability of this approach is yet to be evaluated for pediatric central nervous system (CNS) tumors. Here we show that engineering of a medium-length CAR spacer enhances the therapeutic efficacy of human erb-b2 receptor tyrosine kinase 2 (HER2)-specific CAR T cells in an orthotopic xenograft medulloblastoma model. We translated these findings into BrainChild-01 ( NCT03500991 ), an ongoing phase 1 clinical trial at Seattle Children's evaluating repetitive locoregional dosing of these HER2-specific CAR T cells to children and young adults with recurrent/refractory CNS tumors, including diffuse midline glioma. Primary objectives are assessing feasibility, safety and tolerability; secondary objectives include assessing CAR T cell distribution and disease response. In the outpatient setting, patients receive infusions via CNS catheter into either the tumor cavity or the ventricular system. The initial three patients experienced no dose-limiting toxicity and exhibited clinical, as well as correlative laboratory, evidence of local CNS immune activation, including high concentrations of CXCL10 and CCL2 in the cerebrospinal fluid. This interim report supports the feasibility of generating HER2-specific CAR T cells for repeated dosing regimens and suggests that their repeated intra-CNS delivery might be well tolerated and activate a localized immune response in pediatric and young adult patients.
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Affiliation(s)
- Nicholas A Vitanza
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA. .,Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle, WA, USA.
| | - Adam J Johnson
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA.,Seattle Children's Therapeutics, Seattle, WA, USA
| | - Ashley L Wilson
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA.,Seattle Children's Therapeutics, Seattle, WA, USA
| | - Christopher Brown
- Seattle Children's Therapeutics, Seattle, WA, USA.,Therapeutic Cell Production Core, Seattle Children's Research Institute, Seattle, WA, USA
| | - Jason K Yokoyama
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA.,Seattle Children's Therapeutics, Seattle, WA, USA
| | - Annette Künkele
- Department of Pediatric Oncology and Hematology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Cindy A Chang
- Office of Animal Care, Seattle Children's Research Institute, Seattle, WA, USA
| | - Stephanie Rawlings-Rhea
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA.,Seattle Children's Therapeutics, Seattle, WA, USA
| | - Wenjun Huang
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA.,Seattle Children's Therapeutics, Seattle, WA, USA
| | | | - Catherine M Albert
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle, WA, USA.,Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Navin Pinto
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle, WA, USA.,Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Juliane Gust
- Department of Neurology, University of Washington, Seattle, WA, USA.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Laura S Finn
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA, USA.,Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Jeffrey G Ojemann
- Division of Neurosurgery, Department of Neurological Surgery, Seattle Children's Hospital, Seattle, WA, USA
| | - Jason Wright
- Department of Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Rimas J Orentas
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA.,Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Michael Baldwin
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Rebecca A Gardner
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA.,Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle, WA, USA.,Seattle Children's Therapeutics, Seattle, WA, USA
| | - Michael C Jensen
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle, WA, USA.,Seattle Children's Therapeutics, Seattle, WA, USA.,Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Julie R Park
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Washington, Seattle, WA, USA.,Seattle Children's Therapeutics, Seattle, WA, USA.,Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
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20
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Johnson AJ, Wei J, Rosser JM, Künkele A, Chang CA, Reid AN, Jensen MC. Rationally Designed Transgene-Encoded Cell-Surface Polypeptide Tag for Multiplexed Programming of CAR T-cell Synthetic Outputs. Cancer Immunol Res 2021; 9:1047-1060. [PMID: 34244298 DOI: 10.1158/2326-6066.cir-20-0470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 03/24/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022]
Abstract
Synthetic immunology, as exemplified by chimeric antigen receptor (CAR) T-cell immunotherapy, has transformed the treatment of relapsed/refractory B cell-lineage malignancies. However, there are substantial barriers-including limited tumor homing, lack of retention of function within a suppressive tumor microenvironment, and antigen heterogeneity/escape-to using this technology to effectively treat solid tumors. A multiplexed engineering approach is needed to equip effector T cells with synthetic countermeasures to overcome these barriers. This, in turn, necessitates combinatorial use of lentiviruses because of the limited payload size of current lentiviral vectors. Accordingly, there is a need for cell-surface human molecular constructs that mark multi-vector cotransduced T cells, to enable their purification ex vivo and their tracking in vivo. To this end, we engineered a cell surface-localizing polypeptide tag based on human HER2, designated HER2t, that was truncated in its extracellular and intracellular domains to eliminate ligand binding and signaling, respectively, and retained the membrane-proximal binding epitope of the HER2-specific mAb trastuzumab. We linked HER2t to CAR coexpression in lentivirally transduced T cells and showed that co-transduction with a second lentivirus expressing our previously described EGFRt tag linked to a second CAR efficiently generated bispecific dual-CAR T cells. Using the same approach, we generated T cells expressing a CAR and a second module, a chimeric cytokine receptor. The HER2txEGFRt multiplexing strategy is now being deployed for the manufacture of CD19xCD22 bispecific CAR T-cell products for the treatment of acute lymphoblastic leukemia (NCT03330691).
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Affiliation(s)
- Adam J Johnson
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Seattle Children's Therapeutics, Seattle, Washington
| | - Jia Wei
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Seattle Children's Therapeutics, Seattle, Washington
| | - James M Rosser
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Seattle Children's Therapeutics, Seattle, Washington
| | - Annette Künkele
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Cindy A Chang
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Aquene N Reid
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Seattle Children's Therapeutics, Seattle, Washington
| | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington. .,Seattle Children's Therapeutics, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington.,Department of Bioengineering, University of Washington, Seattle, Washington
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21
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Cardle II, Jensen MC, Pun SH, Sellers DL. Optimized serum stability and specificity of an αvβ6 integrin-binding peptide for tumor targeting. J Biol Chem 2021; 296:100657. [PMID: 33857478 PMCID: PMC8138772 DOI: 10.1016/j.jbc.2021.100657] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/03/2022] Open
Abstract
The integrin αvβ6 is an antigen expressed at low levels in healthy tissue but upregulated during tumorigenesis, which makes it a promising target for cancer imaging and therapy. A20FMDV2 is a 20-mer peptide derived from the foot-and-mouth disease virus that exhibits nanomolar and selective affinity for αvβ6 versus other integrins. Despite this selectivity, A20FMDV2 has had limited success in imaging and treating αvβ6+ tumors in vivo because of its poor serum stability. Here, we explore the cyclization and modification of the A20FMDV2 peptide to improve its serum stability without sacrificing its affinity and specificity for αvβ6. Using cysteine amino acid substitutions and cyclization by perfluoroarylation with decafluorobiphenyl, we synthesized six cyclized A20FMDV2 variants and discovered that two retained binding to αvβ6 with modestly improved serum stability. Further d-amino acid substitutions and C-terminal sequence optimization outside the cyclized region greatly prolonged peptide serum stability without reducing binding affinity. While the cyclized A20FMDV2 variants exhibited increased nonspecific integrin binding compared with the original peptide, additional modifications with the non-natural amino acids citrulline, hydroxyproline, and d-alanine were found to restore binding specificity, with some modifications leading to greater αvβ6 integrin selectivity than the original A20FMDV2 peptide. The peptide modifications detailed herein greatly improve the potential of utilizing A20FMDV2 to target αvβ6 in vivo, expanding opportunities for cancer targeting and therapy.
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Affiliation(s)
- Ian I Cardle
- Department of Bioengineering, University of Washington, Seattle, Washington, USA; Seattle Children's Therapeutics, Seattle, Washington, USA
| | - Michael C Jensen
- Department of Bioengineering, University of Washington, Seattle, Washington, USA; Seattle Children's Therapeutics, Seattle, Washington, USA; Department of Pediatrics, University of Washington, Seattle, Washington, USA; Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Suzie H Pun
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Drew L Sellers
- Department of Bioengineering, University of Washington, Seattle, Washington, USA.
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22
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Brempelis KJ, Cowan CM, Kreuser SA, Labadie KP, Prieskorn BM, Lieberman NAP, Ene CI, Moyes KW, Chinn H, DeGolier KR, Matsumoto LR, Daniel SK, Yokoyama JK, Davis AD, Hoglund VJ, Smythe KS, Balcaitis SD, Jensen MC, Ellenbogen RG, Campbell JS, Pierce RH, Holland EC, Pillarisetty VG, Crane CA. Genetically engineered macrophages persist in solid tumors and locally deliver therapeutic proteins to activate immune responses. J Immunother Cancer 2020; 8:jitc-2020-001356. [PMID: 33115946 PMCID: PMC7594542 DOI: 10.1136/jitc-2020-001356] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background Though currently approved immunotherapies, including chimeric antigen receptor T cells and checkpoint blockade antibodies, have been successfully used to treat hematological and some solid tumor cancers, many solid tumors remain resistant to these modes of treatment. In solid tumors, the development of effective antitumor immune responses is hampered by restricted immune cell infiltration and an immunosuppressive tumor microenvironment (TME). An immunotherapy that infiltrates and persists in the solid TME, while providing local, stable levels of therapeutic to activate or reinvigorate antitumor immunity could overcome these challenges faced by current immunotherapies. Methods Using lentivirus-driven engineering, we programmed human and murine macrophages to express therapeutic payloads, including Interleukin (IL)-12. In vitro coculture studies were used to evaluate the effect of genetically engineered macrophages (GEMs) secreting IL-12 on T cells and on the GEMs themselves. The effects of IL-12 GEMs on gene expression profiles within the TME and tumor burden were evaluated in syngeneic mouse models of glioblastoma and melanoma and in human tumor slices isolated from patients with advanced gastrointestinal malignancies. Results Here, we present a cellular immunotherapy platform using lentivirus-driven genetic engineering of human and mouse macrophages to constitutively express proteins, including secreted cytokines and full-length checkpoint antibodies, as well as cytoplasmic and surface proteins that overcomes these barriers. GEMs traffic to, persist in, and express lentiviral payloads in xenograft mouse models of glioblastoma, and express a non-signaling truncated CD19 surface protein for elimination. IL-12-secreting GEMs activated T cells and induced interferon-gamma (IFNγ) in vitro and slowed tumor growth resulting in extended survival in vivo. In a syngeneic glioblastoma model, IFNγ signaling cascades were also observed in mice treated with mouse bone-marrow-derived GEMs secreting murine IL-12. These findings were reproduced in ex vivo tumor slices comprised of intact MEs. In this setting, IL-12 GEMs induced tumor cell death, chemokines and IFNγ-stimulated genes and proteins. Conclusions Our data demonstrate that GEMs can precisely deliver titratable doses of therapeutic proteins to the TME to improve safety, tissue penetrance, targeted delivery and pharmacokinetics.
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Affiliation(s)
- Katherine J Brempelis
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Courtney M Cowan
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Shannon A Kreuser
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Kevin P Labadie
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Brooke M Prieskorn
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Nicole A P Lieberman
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Chibawanye I Ene
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.,Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Kara W Moyes
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Harrison Chinn
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Kole R DeGolier
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Lisa R Matsumoto
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Sara K Daniel
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Jason K Yokoyama
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Immunotherapy Integration Hub, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Amira D Davis
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Virginia J Hoglund
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Kimberly S Smythe
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Stephanie D Balcaitis
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Immunotherapy Integration Hub, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Richard G Ellenbogen
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
| | - Jean S Campbell
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Robert H Pierce
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Eric C Holland
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.,Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Courtney A Crane
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA .,Discovery and Translational Sciences, Mozart Therapeutics, Seattle, WA, 98119
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23
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Abstract
Chimeric antigen receptor (CAR) T-cell therapy has transformed the cancer treatment landscape, utilizing ex vivo modified autologous T cells to treat relapsed or refractory B-cell leukemias and lymphomas. However, the therapy's broader impact has been limited, in part, by a complicated, lengthy, and expensive production process. Accordingly, as CAR T-cell therapies are further advanced to treat other cancers, continual innovation in cell manufacturing will be critical to their successful clinical implementation. In this Account, we describe our research efforts using biomaterials to improve the three fundamental steps in CAR T-cell manufacturing: (1) isolation, (2) activation, and (3) genetic modification.Recognizing that clinical T-cell isolation reagents have high cost and supply constraints, we developed a synthetic DNA aptamer and complementary reversal agent technology that isolates label-free CD8+ T cells with high purity and yield from peripheral blood mononuclear cells. Encouragingly, CAR T cells manufactured from both antibody- and aptamer-isolated T cells were comparable in therapeutic potency. Discovery and design of other T-cell specific aptamers and corresponding reversal reagents could fully realize the potential of this approach, enabling inexpensive isolation of multiple distinct T-cell populations in a single isolation step.Current ex vivo T-cell activation materials do not accurately mimic in situ T-cell activation by antigen presenting cells (APCs). They cause unequal CD4+ and CD8+ T-cell expansion, necessitating separate production of CD4+ and CD8+ CAR T cells for therapies that call for balanced infusion compositions. To address these shortcomings, we designed a panel of biodegradable cell-templated silica microparticles with supported lipid bilayers that display stimulatory ligands for T-cell activation. High membrane fluidity, elongated shape, and rough surface topography, all properties of endogenous APCs, were found to be favorable parameters for activation, promoting unbiased and efficient CD4/CD8 T-cell expansion while not terminally differentiating the cells.Viral and electroporation-based gene delivery systems have various drawbacks. Viral vectors are expensive and have limited cargo sizes, whereas electroporation is highly cytotoxic. Thus, low-cost nonviral platforms that transfect T cells with low cytotoxicity and high efficiency are needed for CAR gene delivery. Our group thus synthesized a panel of cationic polymers with different architectures and evaluated their T-cell transfection ability. We identified a comb-shaped polymer formulation that transfected primary T cells with low cytotoxicity, although transfection efficiency was low compared to conventional methods. Analysis of intracellular and extracellular barriers to transfection revealed low uptake of polyplexes and high endosomal pH in T cells, alluding to biological and polymer properties that could be further improved.These innovations represent just a few recent developments in the biomaterials field for addressing CAR T-cell production needs. Together, these technologies and their future advancement will pave the way for economical and straightforward CAR T-cell manufacturing.
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Affiliation(s)
- Ian I. Cardle
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, United States
- Research and Development, Seattle Children’s Therapeutics, Seattle, Washington 98101, United States
| | - Emmeline L. Cheng
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, United States
| | - Michael C. Jensen
- Research and Development, Seattle Children’s Therapeutics, Seattle, Washington 98101, United States
- Department of Pediatrics and Department of Bioengineering, University of Washington, Seattle, Washington 98195, United States
- Program in Immunology, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, United States
| | - Suzie H. Pun
- Department of Bioengineering, University of Washington, Seattle, Washington 98195-5061, United States
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24
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Masih KE, Gardner R, Gryder BE, Abdelmaksoud A, Wilson A, Adebola S, Stanton BZ, Song YK, Lack J, Wang C, Wen X, Rae Z, Cheuk A, Altan-Bonnet G, Kelly M, Wei JS, Jensen MC, Orentas RJ, Khan J. Abstract A11: A comprehensive and integrative omic analysis of multiply relapsed refractory pediatric pre-B cell acute lymphoblastic leukemia predicts response to CD19 CAR T-cell therapy. Cancer Res 2020. [DOI: 10.1158/1538-7445.pedca19-a11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Acute lymphoblastic leukemia (ALL) is the most common childhood cancer with a peak incidence at 3-5 years of age. Despite the improved survival rate of 90% for newly diagnosed children with ALL, the outcome for patients with relapsed disease is poor with a less than 30% overall survival. CD19 CAR T-cell therapy has shown remarkable response rates in relapsed/refractory disease. Long-term survival analysis has shown that initial response rates exceed 80%. However, durable response rates at one year are closer to 40%. Little is known about factors predicting durable response to CAR T therapy. We hypothesize that patients with CD19 CAR T-cell resistant ALL have a distinct disease compared to responders to therapy that can be identified in pretreatment leukemia. Utilizing advanced genomic, epigenetic, proteomic, and single-cell (sc) techniques, we characterized patient bone marrow aspirates (BMA) to identify mechanisms of resistance. Patients enrolled in PLAT-02 at Seattle Children’s Hospital were categorized according to the durability of their response to CD19 CAR T therapy. To characterize the molecular and genomic alterations specific to the therapy-resistant ALLs, we performed comprehensive analyses on pre-treatment therapy-resistant and sensitive BMAs using whole-exome sequencing, RNA- BMAs seq, scRNA-seq, sc B cell receptor (BCR)-seq, methylation array, H3K27ac ChIP-seq, ATAC-seq, and CyTOF. Additionally, we developed murine patient-derived xenografts (PDXs) for future studies. Initial mutation analyses revealed 5 hotspot mutations (ABL1, 2 x KRAS, IKZF1, and EP300) and actionable fusion (2 ABL1, 2 ETV6, 2 ETV5, KMT2A). Interestingly, we identified a KMT2A-AFF1 fusion in a sensitive leukemia, which has been demonstrated to predispose patients to CD19 CAR T resistance through lineage switching. Additionally, we identified a novel CREBBP-fusion in leukemias resistant to CD19 CAR T-induced B-cell aplasia. Alterations of CREBBP have previously been associated with ALL that is refractory to conventional therapies. Integrated gene expression and epigenetic analyses are ongoing to identify genes or pathways associated with resistant disease. scRNA- and scBCR-seq data are being analyzed and integrated with CyTOF analyses to detect mixed lineage and gene expression-based heterogeneity that may predict clonal selection by CAR T pressure. Finally, we developed and genetically analyzed murine PDXs for 64% of the patient samples, establishing a valuable resource for future studies and developing novel therapies for resistant leukemias. This study is one of the most integrative and comprehensive genomic profiling approaches to identify the molecular traits of therapy-resistant ALL in patient samples. We hope to identify and develop crucial biomarkers predicting responsiveness to CAR T-cell therapy.
Citation Format: Katherine E. Masih, Rebecca Gardner, Berkley E. Gryder, Abdalla Abdelmaksoud, Ashley Wilson, Serifat Adebola, Benjamin Z. Stanton, Young K. Song, Justin Lack, Chaoyu Wang, Xinyu Wen, Zachary Rae, Adam Cheuk, Gregoire Altan-Bonnet, Michael Kelly, Jun S. Wei, Michael C. Jensen, Rimas J. Orentas, Javed Khan. A comprehensive and integrative omic analysis of multiply relapsed refractory pediatric pre-B cell acute lymphoblastic leukemia predicts response to CD19 CAR T-cell therapy [abstract]. In: Proceedings of the AACR Special Conference on the Advances in Pediatric Cancer Research; 2019 Sep 17-20; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Res 2020;80(14 Suppl):Abstract nr A11.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Justin Lack
- 1National Institutes of Health, Bethesda, MD,
| | - Chaoyu Wang
- 1National Institutes of Health, Bethesda, MD,
| | - Xinyu Wen
- 1National Institutes of Health, Bethesda, MD,
| | - Zachary Rae
- 1National Institutes of Health, Bethesda, MD,
| | - Adam Cheuk
- 1National Institutes of Health, Bethesda, MD,
| | | | | | - Jun S. Wei
- 1National Institutes of Health, Bethesda, MD,
| | | | | | - Javed Khan
- 1National Institutes of Health, Bethesda, MD,
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25
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Gardner RA, Annesley C, Wilson A, Summers C, Narayanaswamy, P, Wu V, Huang W, Johnson A, Li A, Schultz KR, Lindgren C, Mgebroff S, Brown C, Park JR, Jensen MC. Efficacy of SCRI-CAR19x22 T cell product in B-ALL and persistence of anti-CD22 activity. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.3035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3035 Background: Loss of CD19 expression is a major cause of limited durable B-ALL remission following CD19 CAR T cells, which might be overcome by utilization of dual CD19xCD22 CAR T cell targeting. Methods: A Phase I trial (NCT03330691) of SCRI-CAR19x22 was developed using dual transduction of lentiviral vectors encoding for either a CD19- or CD22-specific CAR T cell construct, both with 4-1BB co-stimulation. Manufacturing was performed in a closed G-Rex system with IL-7, IL-15 and IL-21. After lymphodepletion, CAR T cells were infused at 1 or 3 X 106 CAR T cells/kg dose levels. Leukemic response and CAR T cell persistence were evaluated by flow cytometry. Results: Products were successfully manufactured in all 28 enrolled subjects with 7.92 average days in culture (range of 7-11 days) and consisted of an average CD8:CD4 ratio of 3.09 (range 0.19 to 8.9). The cellular product CAR composition was 29% CD19, 31% CD22 and 39% CD19 and CD22 targeting. 13 subjects had prior exposure to CD19 or CD22 targeting therapies with diverse expression of CD19 and CD22 on the leukemic blasts. No dose limiting toxicities occurred in the 27 infused subjects. The recommended phase 2 dose is 3 x 106 CAR+ cells/kg. CRS was present in 80% of subjects, with 85% of CRS being grade 2 or less, and a peak grade of 3 (n = 3). Mild neurotoxicity occurred in 38%, with a single grade 3 event. 84.6% obtained a CR, of which 95% were MRD negative. Of the 4 subjects who did not achieved a CR, 2 had a pre-existing CD19 negative population and one had previously received CAR T cells and rejected SCRI-CAR19x22. There have been 4 relapses with varying CD19 and CD22 expression as follows: 1 CD19-CD22-, 1 CD19+CD22+, and 2 CD19-CD22+. The in vivo engraftment of CAR T cells peaked most frequently between day +7 and +14 and was predominated by the CD19 CAR+ T cells. Conclusions: We demonstrate manufacturing feasibility and safety of SCRI-CAR19x22. While initial efficacy is demonstrated, CD22 activity is poor due to limited expansion of the CD22 CAR-containing components and subjects with pre-existing CD19 negative leukemia fared poorly. Development of a revised CD22 CAR that exhibits a reduction tonic signaling is underway, with plans to explore the new construct in the context of a dual-targeting CD19xCD22 CAR T cell product. Clinical trial information: NCT03330691 .
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Affiliation(s)
| | | | | | - Corinne Summers
- University of Washington/Seattle Children's Hospital, Seattle, WA
| | | | - Vicky Wu
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Wenjun Huang
- Seattle Children's Research Institute, Seattle, WA
| | - Adam Johnson
- Seattle Children's Research Institute, Seattle, WA
| | - Amanda Li
- British Columbia Children's, Vancouver, BC, Canada
| | | | | | | | | | - Julie R. Park
- Seattle Children's Hospital and University of Washington School of Medicine, Seattle, WA
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26
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Ali S, Toews K, Schwiebert S, Klaus A, Winkler A, Grunewald L, Oevermann L, Deubzer HE, Tüns A, Jensen MC, Henssen AG, Eggert A, Schulte JH, Schwich E, Rebmann V, Schramm A, Künkele A. Tumor-Derived Extracellular Vesicles Impair CD171-Specific CD4 + CAR T Cell Efficacy. Front Immunol 2020; 11:531. [PMID: 32296437 PMCID: PMC7137471 DOI: 10.3389/fimmu.2020.00531] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/09/2020] [Indexed: 12/18/2022] Open
Abstract
Chimeric antigen receptor (CAR) T cell efficacy against solid tumors is currently limited by several immune escape mechanisms, which may include tumor-derived extracellular vesicles. Advanced neuroblastoma is an aggressive childhood tumor without curative treatment options for most relapsed patients today. We here evaluated the role of tumor-derived extracellular vesicles on the efficacy of CAR T cells targeting the neuroblastoma-specific antigen, CD171. For this purpose, CAR T cell activation, cytokine production, exhaustion, and tumor cell-directed cytotoxicity upon co-culture was evaluated. Tumor-derived extracellular vesicles isolated from SH-SY5Y neuroblastoma cells neither affected CAR T cell activation nor expression of inhibitory markers. Importantly, exposure of CD4+ CD171-specific CAR T cells to tumor-derived extracellular vesicles significantly impaired tumor cytotoxicity of CAR T cells. This effect was independent of neurotrophic receptor tyrosine kinases 1 or 2 (NTRK1, NTRK2) expression, which is known to impact immune responses against neuroblastoma. Our results demonstrate for the first time the impact of tumor-derived extracellular vesicles and non-cell-mediated tumor-suppressive effects on CD4+ CAR T cell efficacy in a preclinical setting. We conclude that these factors should be considered for any CAR T cell-based therapy to make CAR T cell therapy successful against solid tumors.
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Affiliation(s)
- Solin Ali
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Karin Toews
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Silke Schwiebert
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anika Klaus
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Annika Winkler
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Laura Grunewald
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lena Oevermann
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Hedwig E Deubzer
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Neuroblastoma Research Group, Experimental and Clinical Research Center (ECRC) of the Charité and the Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alicia Tüns
- Department of Internal Medicine, University Duisburg-Essen, Essen, Germany
| | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, United States.,Fred Hutchinson Cancer Research Center, Seattle, WA, United States.,University of Washington, Department of Bioengineering, Seattle, WA, United States
| | - Anton G Henssen
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Angelika Eggert
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Johannes H Schulte
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Esther Schwich
- Department of Transfusion Medicine, University Duisburg-Essen, Essen, Germany
| | - Vera Rebmann
- Department of Transfusion Medicine, University Duisburg-Essen, Essen, Germany
| | - Alexander Schramm
- Department of Internal Medicine, University Duisburg-Essen, Essen, Germany
| | - Annette Künkele
- Department of Pediatric Oncology and Hematology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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27
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Ravanpay AC, Gust J, Johnson AJ, Rolczynski LS, Cecchini M, Chang CA, Hoglund VJ, Mukherjee R, Vitanza NA, Orentas RJ, Jensen MC. EGFR806-CAR T cells selectively target a tumor-restricted EGFR epitope in glioblastoma. Oncotarget 2019; 10:7080-7095. [PMID: 31903167 PMCID: PMC6925027 DOI: 10.18632/oncotarget.27389] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 12/02/2019] [Indexed: 12/31/2022] Open
Abstract
Targeting solid tumor antigens with chimeric antigen receptor (CAR) T cell therapy requires tumor specificity and tolerance toward variability in antigen expression levels. Given the relative paucity of unique cell surface proteins on tumor cells for CAR targeting, we have focused on identifying tumor-specific epitopes that arise as a consequence of target protein posttranslational modification. We designed a CAR using a mAb806-based binder, which recognizes tumor-specific untethered EGFR. The mAb806 epitope is also exposed in the EGFRvIII variant transcript. By varying spacer domain elements of the CAR, we structurally tuned the CAR to recognize low densities of EGFR representative of non-gene amplified expression levels in solid tumors. The appropriately tuned short-spacer 2nd generation EGFR806-CAR T cells showed efficient in vitro cytokine secretion and glioma cell lysis, which was competitively blocked by a short peptide encompassing the mAb806 binding site. Unlike the nonselective Erbitux-based CAR, EGFR806-CAR T cells did not target primary human fetal brain astrocytes expressing wild-type EGFR, but showed a similar level of activity compared to Erbitux-CAR when the tumor-specific EGFRvIII transcript variant was overexpressed in astrocytes. EGFR806-CAR T cells successfully treated orthotopic U87 glioma implants in NSG mice, with 50% of animals surviving to 90 days. With additional IL-2 support, all tumors were eradicate without recurrence after 90 days. In a novel human induced pluripotent stem cell (iPSC)-derived teratoma xenograft model, EGFR806-CAR T cells infiltrated but were not activated in EGFR+ epidermal cell nests as assessed by Granzyme B expression. These results indicate that EGFR806-CAR T cells effectively and selectively target EGFR-expressing tumor cells.
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Affiliation(s)
- Ali C Ravanpay
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, U.S.A.,University of Washington, Department of Neurological Surgery, Seattle, WA, U.S.A
| | - Juliane Gust
- University of Washington, Department of Neurology, Seattle, WA, U.S.A.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, U.S.A
| | - Adam J Johnson
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, U.S.A
| | - Lisa S Rolczynski
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, U.S.A
| | - Michelle Cecchini
- University of Washington, Department of Neurological Surgery, Seattle, WA, U.S.A
| | - Cindy A Chang
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, U.S.A
| | - Virginia J Hoglund
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, U.S.A
| | - Rithun Mukherjee
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, U.S.A
| | - Nicholas A Vitanza
- Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, U.S.A.,University of Washington, Department of Pediatrics, Seattle, WA, U.S.A
| | - Rimas J Orentas
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, U.S.A.,University of Washington, Department of Pediatrics, Seattle, WA, U.S.A
| | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, U.S.A.,University of Washington, Department of Pediatrics, Seattle, WA, U.S.A.,University of Washington, Department of Bioengineering, Seattle, WA, U.S.A
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28
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Gardner RA, Ceppi F, Rivers J, Annesley C, Summers C, Taraseviciute A, Gust J, Leger KJ, Tarlock K, Cooper TM, Finney OC, Brakke H, Li DH, Park JR, Jensen MC. Preemptive mitigation of CD19 CAR T-cell cytokine release syndrome without attenuation of antileukemic efficacy. Blood 2019; 134:2149-2158. [PMID: 31697826 PMCID: PMC6908832 DOI: 10.1182/blood.2019001463] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/25/2019] [Indexed: 12/14/2022] Open
Abstract
Immunotherapy with the adoptive transfer of T cells redirected with CD19-specific chimeric antigen receptors (CARs) for B-lineage acute lymphoblastic leukemia (ALL) can salvage >80% of patients having relapsed/refractory disease. The therapeutic index of this emerging modality is attenuated by the occurrence of immunologic toxicity syndromes that occur upon CAR T-cell engraftment. Here, we report on the low incidence of severe cytokine release syndrome (CRS) in a subject treated with a CAR T-cell product composed of a defined ratio CD4:CD8 T-cell composition with a 4-1BB:zeta CAR targeting CD19 who also recieved early intervention treatment. We report that early intervention with tocilizumab and/or corticosteroids may reduce the frequency at which subjects transition from mild CRS to severe CRS. Although early intervention doubled the numbers of subjects dosed with tocilizumab and/or corticosteroids, there was no apparent detrimental effect on minimal residual disease-negative complete remission rates or subsequent persistence of functional CAR T cells compared with subjects who did not receive intervention. Moreover, early intervention therapy did not increase the proportion of subjects who experience neurotoxicity or place subjects at risk for infectious sequelae. These data support the contention that early intervention with tocilizumab and/or corticosteroids in subjects with early signs of CRS is without negative impact on the antitumor potency of CD19 CAR T cells. This intervention serves to enhance the therapeutic index in relapsed/refractory patients and provides the rationale to apply CAR T-cell therapy more broadly in ALL therapy. This trial was registered at www.clinicaltrials.gov as #NCT020284.
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MESH Headings
- Adolescent
- Adrenal Cortex Hormones/administration & dosage
- Adrenal Cortex Hormones/pharmacology
- Adult
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/pharmacology
- Antigens, CD19/immunology
- Antigens, CD19/metabolism
- Child
- Child, Preschool
- Cytokine Release Syndrome/etiology
- Cytokine Release Syndrome/metabolism
- Cytokines/blood
- Cytokines/metabolism
- Dose-Response Relationship, Drug
- Female
- Humans
- Immunotherapy, Adoptive/adverse effects
- Immunotherapy, Adoptive/methods
- Incidence
- Infant
- Male
- Neoplasm Grading
- Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/complications
- Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/immunology
- Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/metabolism
- Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/therapy
- Receptors, Antigen, T-Cell/metabolism
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/metabolism
- T-Lymphocyte Subsets/pathology
- Young Adult
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Affiliation(s)
- Rebecca A Gardner
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics and
| | | | - Julie Rivers
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics and
| | - Colleen Annesley
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics and
| | - Corinne Summers
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics and
| | - Agne Taraseviciute
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics and
| | - Juliane Gust
- Seattle Children's Research Institute, Seattle, WA
- Department of Neurology, University of Washington, Seattle, WA; and
| | - Kasey J Leger
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics and
| | - Katherine Tarlock
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics and
| | - Todd M Cooper
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics and
| | | | | | - Daniel H Li
- Clinical Statistics Group, Juno Therapeutics, Inc., Seattle, WA
| | - Julie R Park
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics and
| | - Michael C Jensen
- Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics and
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29
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Balakrishnan A, Rajan A, Salter AI, Kosasih PL, Wu Q, Voutsinas J, Jensen MC, Plückthun A, Riddell SR. Multispecific Targeting with Synthetic Ankyrin Repeat Motif Chimeric Antigen Receptors. Clin Cancer Res 2019; 25:7506-7516. [PMID: 31548346 DOI: 10.1158/1078-0432.ccr-19-1479] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/17/2019] [Accepted: 09/06/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE The outgrowth of antigen-negative variants is a significant challenge for adoptive therapy with T cells that target a single specificity. Chimeric antigen receptors (CAR) are typically designed with one or two scFvs that impart antigen specificity fused to activation and costimulation domains of T-cell signaling molecules. We designed and evaluated the function of CARs with up to three specificities for overcoming tumor escape using Designed Ankyrin Repeat Proteins (DARPins) rather than scFvs for tumor recognition. EXPERIMENTAL DESIGN A monospecific CAR was designed with a DARPin binder (E01) specific for EGFR and compared with a CAR designed using an anti-EGFR scFv. CAR constructs in which DARPins specific for EGFR, EpCAM, and HER2 were linked together in a single CAR were then designed and optimized to achieve multispecific tumor recognition. The efficacy of CAR-T cells bearing a multispecific DARPin CAR for treating tumors with heterogeneous antigen expression was evaluated in vivo. RESULTS The monospecific anti-EGFR E01 DARPin conferred potent tumor regression against EGFR+ targets that was comparable with an anti-EGFR scFv CAR. Linking three separate DARPins in tandem was feasible and in an optimized format generated a single tumor recognition domain that targeted a mixture of heterogeneous tumor cells, each expressing a single antigen, and displayed synergistic activity when tumor cells expressed more than one target antigen. CONCLUSIONS DARPins can serve as high-affinity recognition motifs for CAR design, and their robust architecture enables linking of multiple binders against different antigens to achieve functional synergy and reduce antigen escape.
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Affiliation(s)
- Ashwini Balakrishnan
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Anusha Rajan
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Alexander I Salter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.,University of Washington, Seattle, Washington
| | - Paula L Kosasih
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Qian Wu
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Jenna Voutsinas
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Michael C Jensen
- University of Washington, Seattle, Washington.,Seattle Children's Research Institute, Seattle, Washington
| | - Andreas Plückthun
- Department of Biochemistry, University of Zurich, Zurich, Switzerland
| | - Stanley R Riddell
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. .,University of Washington, Seattle, Washington
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30
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Andersch L, Radke J, Klaus A, Schwiebert S, Winkler A, Schumann E, Grunewald L, Zirngibl F, Flemmig C, Jensen MC, Rossig C, Joussen A, Henssen A, Eggert A, Schulte JH, Künkele A. CD171- and GD2-specific CAR-T cells potently target retinoblastoma cells in preclinical in vitro testing. BMC Cancer 2019; 19:895. [PMID: 31500597 PMCID: PMC6732842 DOI: 10.1186/s12885-019-6131-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/03/2019] [Indexed: 12/14/2022] Open
Abstract
Background Chimeric antigen receptor (CAR)-based T cell therapy is in early clinical trials to target the neuroectodermal tumor, neuroblastoma. No preclinical or clinical efficacy data are available for retinoblastoma to date. Whereas unilateral intraocular retinoblastoma is cured by enucleation of the eye, infiltration of the optic nerve indicates potential diffuse scattering and tumor spread leading to a major therapeutic challenge. CAR-T cell therapy could improve the currently limited therapeutic strategies for metastasized retinoblastoma by simultaneously killing both primary tumor and metastasizing malignant cells and by reducing chemotherapy-related late effects. Methods CD171 and GD2 expression was flow cytometrically analyzed in 11 retinoblastoma cell lines. CD171 expression and T cell infiltration (CD3+) was immunohistochemically assessed in retrospectively collected primary retinoblastomas. The efficacy of CAR-T cells targeting the CD171 and GD2 tumor-associated antigens was preclinically tested against three antigen-expressing retinoblastoma cell lines. CAR-T cell activation and exhaustion were assessed by cytokine release assays and flow cytometric detection of cell surface markers, and killing ability was assessed in cytotoxic assays. CAR constructs harboring different extracellular spacer lengths (short/long) and intracellular co-stimulatory domains (CD28/4-1BB) were compared to select the most potent constructs. Results All retinoblastoma cell lines investigated expressed CD171 and GD2. CD171 was expressed in 15/30 primary retinoblastomas. Retinoblastoma cell encounter strongly activated both CD171-specific and GD2-specific CAR-T cells. Targeting either CD171 or GD2 effectively killed all retinoblastoma cell lines examined. Similar activation and killing ability for either target was achieved by all CAR constructs irrespective of the length of the extracellular spacers and the co-stimulatory domain. Cell lines differentially lost tumor antigen expression upon CAR-T cell encounter, with CD171 being completely lost by all tested cell lines and GD2 further down-regulated in cell lines expressing low GD2 levels before CAR-T cell challenge. Alternating the CAR-T cell target in sequential challenges enhanced retinoblastoma cell killing. Conclusion Both CD171 and GD2 are effective targets on human retinoblastoma cell lines, and CAR-T cell therapy is highly effective against retinoblastoma in vitro. Targeting of two different antigens by sequential CAR-T cell applications enhanced tumor cell killing and preempted tumor antigen loss in preclinical testing. Supplementary information Supplementary information accompanies this paper at 10.1186/s12885-019-6131-1.
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Affiliation(s)
- Lena Andersch
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Josefine Radke
- Department of Neuropathology, Charitéplatz 1, Charité, Universitätsmedizin Berlin, 10117, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, CCCC (Campus Mitte), Invalidenstr. 80, 10115, Berlin, Germany
| | - Anika Klaus
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Silke Schwiebert
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Annika Winkler
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Elisa Schumann
- Department of Neuropathology, Charitéplatz 1, Charité, Universitätsmedizin Berlin, 10117, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, CCCC (Campus Mitte), Invalidenstr. 80, 10115, Berlin, Germany
| | - Laura Grunewald
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Felix Zirngibl
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
| | - Carina Flemmig
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
| | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA, USA.,Seattle Children's Research Institute, Seattle, WA, USA.,Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Claudia Rossig
- Department of Pediatric Hematology and Oncology, University Children's Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany
| | - Antonia Joussen
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany
| | - Anton Henssen
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany
| | - Angelika Eggert
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, CCCC (Campus Mitte), Invalidenstr. 80, 10115, Berlin, Germany.,German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Johannes H Schulte
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, CCCC (Campus Mitte), Invalidenstr. 80, 10115, Berlin, Germany.,German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Annette Künkele
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany. .,Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany. .,German Cancer Consortium (DKTK), Partner Site Berlin, CCCC (Campus Mitte), Invalidenstr. 80, 10115, Berlin, Germany.
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31
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Gust J, Finney OC, Li D, Brakke HM, Hicks RM, Futrell RB, Gamble DN, Rawlings-Rhea SD, Khalatbari HK, Ishak GE, Duncan VE, Hevner RF, Jensen MC, Park JR, Gardner RA. Glial injury in neurotoxicity after pediatric CD19-directed chimeric antigen receptor T cell therapy. Ann Neurol 2019; 86:42-54. [PMID: 31074527 DOI: 10.1002/ana.25502] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To test whether systemic cytokine release is associated with central nervous system inflammatory responses and glial injury in immune effector cell-associated neurotoxicity syndrome (ICANS) after chimeric antigen receptor (CAR)-T cell therapy in children and young adults. METHODS We performed a prospective cohort study of clinical manifestations as well as imaging, pathology, CSF, and blood biomarkers on 43 subjects ages 1 to 25 who received CD19-directed CAR/T cells for acute lymphoblastic leukemia (ALL). RESULTS Neurotoxicity occurred in 19 of 43 (44%) subjects. Nine subjects (21%) had CTCAE grade 3 or 4 neurological symptoms, with no neurotoxicity-related deaths. Reversible delirium, headache, decreased level of consciousness, tremor, and seizures were most commonly observed. Cornell Assessment of Pediatric Delirium (CAPD) scores ≥9 had 94% sensitivity and 33% specificity for grade ≥3 neurotoxicity, and 91% sensitivity and 72% specificity for grade ≥2 neurotoxicity. Neurotoxicity correlated with severity of cytokine release syndrome, abnormal past brain magnetic resonance imaging (MRI), and higher peak CAR-T cell numbers in blood, but not cerebrospinal fluid (CSF). CSF levels of S100 calcium-binding protein B and glial fibrillary acidic protein increased during neurotoxicity, indicating astrocyte injury. There were concomitant increases in CSF white blood cells, protein, interferon-γ (IFNγ), interleukin (IL)-6, IL-10, and granzyme B (GzB), with concurrent elevation of serum IFNγ IL-10, GzB, granulocyte macrophage colony-stimulating factor, macrophage inflammatory protein 1 alpha, and tumor necrosis factor alpha, but not IL-6. We did not find direct evidence of endothelial activation. INTERPRETATION Our data are most consistent with ICANS as a syndrome of systemic inflammation, which affects the brain through compromise of the neurovascular unit and astrocyte injury. ANN NEUROL 2019.
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Affiliation(s)
- Juliane Gust
- Seattle Children's Division of Pediatric Neurology, Department of Neurology, University of Washington, Seattle, WA.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA
| | - Olivia C Finney
- Seattle Children's Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA
| | | | - Hannah M Brakke
- Seattle Children's Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA
| | - Roxana M Hicks
- Seattle Children's Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA
| | - Robert B Futrell
- Seattle Children's Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA
| | - Danielle N Gamble
- Seattle Children's Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA
| | - Stephanie D Rawlings-Rhea
- Seattle Children's Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA
| | | | | | | | - Robert F Hevner
- Department of Pathology, University of California San Diego, San Diego, CA
| | - Michael C Jensen
- Seattle Children's Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA.,Seattle Children's Division of Hematology-Oncology, Seattle, WA
| | - Julie R Park
- Seattle Children's Division of Hematology-Oncology, Seattle, WA
| | - Rebecca A Gardner
- Seattle Children's Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA.,Seattle Children's Division of Hematology-Oncology, Seattle, WA
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32
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Finney OC, Brakke H, Rawlings-Rhea S, Hicks R, Doolittle D, Lopez M, Futrell B, Orentas RJ, Li D, Gardner R, Jensen MC. CD19 CAR T cell product and disease attributes predict leukemia remission durability. J Clin Invest 2019; 129:2123-2132. [PMID: 30860496 PMCID: PMC6486329 DOI: 10.1172/jci125423] [Citation(s) in RCA: 221] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Chimeric antigen receptor (CAR) T cells can induce remission in highly refractory leukemia and lymphoma subjects, yet the parameters for achieving sustained relapse-free survival are not fully delineated. METHODS We analyzed 43 pediatric and young adult subjects participating in a Phase I trial of defined composition CD19CAR T cells (NCT02028455). CAR T cell phenotype, function and expansion, as well as starting material T cell repertoire, were analyzed in relation to therapeutic outcome (defined as achieving complete remission within 63 days) and duration of leukemia free survival and B cell aplasia. RESULTS These analyses reveal that initial therapeutic failures (n = 5) were associated with attenuated CAR T cell expansion and/or rapid attrition of functional CAR effector cells following adoptive transfer. The CAR T products were similar in phenotype and function when compared to products resulting in sustained remissions. However, the initial apheresed peripheral blood T cells could be distinguished by an increased frequency of LAG-3+/TNF-αlow CD8 T cells and, following adoptive transfer, the rapid expression of exhaustion markers. For the 38 subjects who achieved an initial sustained MRD-neg remission, remission durability correlated with therapeutic products having increased frequencies of TNF-α-secreting CAR CD8+ T cells, and was dependent on a sufficiently high CD19+ antigen load at time of infusion to trigger CAR T cell proliferation. CONCLUSION These parameters have the potential to prospectively identify patients at risk for therapeutic failure and support the development of approaches to boost CAR T cell activation and proliferation in patients with low levels of CD19 antigen. TRIAL REGISTRATION ClinicalTrials.gov NCT02028455. FUNDING Partial funding for this study was provided by Stand Up to Cancer & St. Baldrick's Pediatric Dream Team Translational Research Grant (SU2C-AACR-DT1113), RO1 CA136551-05, Alex Lemonade Stand Phase I/II Infrastructure Grant, Conquer Cancer Foundation Career Development Award, Washington State Life Sciences Discovery Fund, Ben Towne Foundation, William Lawrence & Blanche Hughes Foundation, and Juno Therapeutics, Inc., a Celgene Company.
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Affiliation(s)
- Olivia C. Finney
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Hannah Brakke
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Stephanie Rawlings-Rhea
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Roxana Hicks
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Danielle Doolittle
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Marisa Lopez
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Ben Futrell
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Rimas J. Orentas
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Daniel Li
- Clinical Statistics Group, Juno Therapeutics, Inc., Seattle, Washington, USA
| | - Rebecca Gardner
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA.,Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Michael C. Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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33
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Lu YJ, Chu H, Wheeler LW, Nelson M, Westrick E, Matthaei JF, Cardle II, Johnson A, Gustafson J, Parker N, Vetzel M, Xu LC, Wang EZ, Jensen MC, Klein PJ, Low PS, Leamon CP. Preclinical Evaluation of Bispecific Adaptor Molecule Controlled Folate Receptor CAR-T Cell Therapy With Special Focus on Pediatric Malignancies. Front Oncol 2019; 9:151. [PMID: 30941303 PMCID: PMC6433934 DOI: 10.3389/fonc.2019.00151] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 02/22/2019] [Indexed: 12/25/2022] Open
Abstract
Chimeric antigen receptor (CAR)-T cell therapy has transformed pediatric oncology by producing high remission rates and potent effects in CD19+ B-cell malignancies. This scenario is ideal as CD19 expression is homogeneous and human blood provides a favorable environment for CAR-T cells to thrive and destroy cancer cells (along with normal B cells). Yet, CAR-T cell therapies for solid tumors remain challenged by fewer tumor targets and poor CAR-T cell performances in a hostile tumor microenvironment. For acute myeloid leukemia and childhood solid tumors such as osteosarcoma, the primary treatment is systemic chemotherapy that often falls short of expectation especially for relapsed and refractory conditions. We aim to develop a CAR-T adaptor molecule (CAM)-based therapy that uses a bispecific small-molecule ligand EC17, fluorescein isothiocyanate (FITC) conjugated with folic acid, to redirect FITC-specific CAR-T cells against folate receptor (FR)-positive tumors. As previously confirmed in rodents as well as in human clinical studies, EC17 penetrates solid tumors within minutes and is retained due to high affinity for the FR, whereas unbound EC17 rapidly clears from the blood and from receptor-negative tissues. When combined with a rationally designed CAR construct, EC17 CAM was shown to trigger CAR-modified T cell activation and cytolytic activity with a low FR threshold against tumor targets. However, maximal cytolytic potential correlated with (i) functional FR levels (in a semi-log fashion), (ii) the amount of effector cells present, and (iii) tumors' natural sensitivity to T cell mediated killing. In tumor-bearing mice, administration of EC17 CAM was the key to drive CAR-T cell activation, proliferation, and persistence against FR+ pediatric hematologic and solid tumors. In our modeling systems, cytokine release syndrome (CRS) was induced under specific conditions, but the risk of severe CRS could be easily mitigated or prevented by applying intermittent dosing and/or dose-titration strategies for the EC17 CAM. Our approach offers the flexibility of antigen control, prevents T cell exhaustion, and provides additional safety mechanisms including rapid reversal of severe CRS with intravenous sodium fluorescein. In this paper, we summarize the translational aspects of our technology in support of clinical development.
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Affiliation(s)
| | - Haiyan Chu
- Endocyte, Inc., West Lafayette, IN, United States
| | | | | | | | - James F Matthaei
- Ben Towne Center for Childhood Cancer Research (BTCCCR), Seattle Children's Research Institute, Seattle, WA, United States
| | - Ian I Cardle
- Ben Towne Center for Childhood Cancer Research (BTCCCR), Seattle Children's Research Institute, Seattle, WA, United States
| | - Adam Johnson
- Ben Towne Center for Childhood Cancer Research (BTCCCR), Seattle Children's Research Institute, Seattle, WA, United States
| | - Joshua Gustafson
- Ben Towne Center for Childhood Cancer Research (BTCCCR), Seattle Children's Research Institute, Seattle, WA, United States
| | - Nikki Parker
- Endocyte, Inc., West Lafayette, IN, United States
| | | | - Le-Cun Xu
- Endocyte, Inc., West Lafayette, IN, United States
| | | | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research (BTCCCR), Seattle Children's Research Institute, Seattle, WA, United States
| | | | - Philip S Low
- Endocyte, Inc., West Lafayette, IN, United States.,Department of Chemistry, Purdue University, West Lafayette, IN, United States
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34
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Olden BR, Perez CR, Wilson AL, Cardle II, Lin YS, Kaehr B, Gustafson JA, Jensen MC, Pun SH. Cell-Templated Silica Microparticles with Supported Lipid Bilayers as Artificial Antigen-Presenting Cells for T Cell Activation. Adv Healthc Mater 2019; 8:e1801188. [PMID: 30549244 PMCID: PMC6394850 DOI: 10.1002/adhm.201801188] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 11/28/2018] [Indexed: 01/18/2023]
Abstract
Biomaterial properties that modulate T cell activation, growth, and differentiation are of significant interest in the field of cellular immunotherapy manufacturing. In this work, a new platform technology that allows for the modulation of various activation particle design parameters important for polyclonal T cell activation is presented. Artificial antigen presenting cells (aAPCs) are successfully created using supported lipid bilayers on various cell-templated silica microparticles with defined membrane fluidity and stimulating antibody density. This panel of aAPCs is used to probe the importance of activation particle shape, size, membrane fluidity, and stimulation antibody density on T cell outgrowth and differentiation. All aAPC formulations are able to stimulate T cell growth, and preferentially promote CD8+ T cell growth over CD4+ T cell growth when compared to commercially available pendant antibody-conjugated particles. T cells cultured with HeLa- and red blood cell-templated aAPCs have a less-differentiated and less-exhausted phenotype than those cultured with spherical aAPCs with matched membrane coatings when cultured for 14 days. These results support continued exploration of silica-supported lipid bilayers as an aAPC platform.
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Affiliation(s)
- Brynn R. Olden
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, Seattle, WA 98195, USA,
| | - Caleb R. Perez
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, Seattle, WA 98195, USA,
| | - Ashley L. Wilson
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Ian I. Cardle
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, Seattle, WA 98195, USA,
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Yu-Shen Lin
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, Seattle, WA 98195, USA,
| | - Bryan Kaehr
- Advanced Materials Laboratory, Sandia National Laboratories, Albuquerque, NM 87185, USA
| | - Joshua A. Gustafson
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Michael C. Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Suzie H. Pun
- Department of Bioengineering and Molecular Engineering and Sciences Institute, University of Washington, Seattle, WA 98195, USA,
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Lu YJ, Chu H, Wheeler LW, Nelson M, Westrick EM, Vetzel MR, Klein PJ, Johnson AJ, Yokoyama JK, Gustafson JA, Jensen MC, Lee YG, Low PS, Leamon CP. Abstract LB-109: Adaptor controlled CAR-T cell immunotherapy for treatment of folate receptor-alpha/beta positive solid and liquid tumors. Immunology 2018. [DOI: 10.1158/1538-7445.am2018-lb-109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Pennell CA, Barnum JL, McDonald-Hyman CS, Panoskaltsis-Mortari A, Riddle MJ, Xiong Z, Loschi M, Thangavelu G, Campbell HM, Storlie MD, Refaeli Y, Furlan SN, Jensen MC, Kean LS, Miller JS, Tolar J, Osborn MJ, Blazar BR. Human CD19-Targeted Mouse T Cells Induce B Cell Aplasia and Toxicity in Human CD19 Transgenic Mice. Mol Ther 2018; 26:1423-1434. [PMID: 29735365 PMCID: PMC5986973 DOI: 10.1016/j.ymthe.2018.04.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/02/2018] [Accepted: 04/04/2018] [Indexed: 01/28/2023] Open
Abstract
The clinical success of chimeric antigen receptor (CAR) T cell therapy for CD19+ B cell malignancies can be limited by acute toxicities and immunoglobulin replacement needs due to B cell aplasia from persistent CAR T cells. Life-threatening complications include cytokine release syndrome and neurologic adverse events, the exact etiologies of which are unclear. To elucidate the underlying toxicity mechanisms and test potentially safer CAR T cells, we developed a mouse model in which human CD19 (hCD19)-specific mouse CAR T cells were adoptively transferred into mice whose normal B cells express a hCD19 transgene at hemizygous levels. Compared to homozygous hCD19 transgenic mice that have ∼75% fewer circulating B cells, hemizygous mice had hCD19 frequencies and antigen density more closely simulating human B cells. Hemizygous mice given a lethal dose of hCD19 transgene-expressing lymphoma cells and treated with CAR T cells had undetectable tumor levels. Recipients experienced B cell aplasia and antigen- and dose-dependent acute toxicities mirroring patient complications. Interleukin-6 (IL-6), interferon γ (IFN-γ), and inflammatory pathway transcripts were enriched in affected tissues. As in patients, antibody-mediated neutralization of IL-6 (and IFN-γ) blunted toxicity. Apparent behavioral abnormalities associated with decreased microglial cells point to CAR-T-cell-induced neurotoxicity. This model will prove useful in testing strategies designed to improve hCD19-specific CAR T cell safety.
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Affiliation(s)
- Christopher A Pennell
- Department of Laboratory Medicine and Pathology, Masonic Cancer Center, Center for Immunology, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Jessie L Barnum
- Division of Blood and Marrow Transplantation, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Cameron S McDonald-Hyman
- Division of Blood and Marrow Transplantation, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Angela Panoskaltsis-Mortari
- Division of Blood and Marrow Transplantation, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Megan J Riddle
- Stem Cell Institute, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Zhengming Xiong
- Division of Hematology and Oncology, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Michael Loschi
- Division of Blood and Marrow Transplantation, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Govindarajan Thangavelu
- Division of Blood and Marrow Transplantation, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Heather M Campbell
- Department of Laboratory Medicine and Pathology, Masonic Cancer Center, Center for Immunology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Meghan D Storlie
- Department of Laboratory Medicine and Pathology, Masonic Cancer Center, Center for Immunology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Yosef Refaeli
- Department of Dermatology, University of Colorado, Aurora, CO 80045, USA
| | - Scott N Furlan
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, The Ben Towne Center for Childhood Cancer, The Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA 98101, USA
| | - Michael C Jensen
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, The Ben Towne Center for Childhood Cancer, The Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA 98101, USA
| | - Leslie S Kean
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, The Ben Towne Center for Childhood Cancer, The Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA 98101, USA
| | - Jeffrey S Miller
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Jakub Tolar
- Division of Blood and Marrow Transplantation, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA; Stem Cell Institute, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Mark J Osborn
- Division of Blood and Marrow Transplantation, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bruce R Blazar
- Division of Blood and Marrow Transplantation, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
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Taraseviciute A, Tkachev V, Ponce R, Turtle CJ, Snyder JM, Liggitt HD, Myerson D, Gonzalez-Cuyar L, Baldessari A, English C, Yu A, Zheng H, Furlan SN, Hunt DJ, Hoglund V, Finney O, Brakke H, Blazar BR, Berger C, Riddell SR, Gardner R, Kean LS, Jensen MC. Chimeric Antigen Receptor T Cell-Mediated Neurotoxicity in Nonhuman Primates. Cancer Discov 2018; 8:750-763. [PMID: 29563103 PMCID: PMC6058704 DOI: 10.1158/2159-8290.cd-17-1368] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/03/2018] [Accepted: 03/12/2018] [Indexed: 12/22/2022]
Abstract
Chimeric antigen receptor (CAR) T-cell immunotherapy has revolutionized the treatment of refractory leukemias and lymphomas, but is associated with significant toxicities, namely cytokine release syndrome (CRS) and neurotoxicity. A major barrier to developing therapeutics to prevent CAR T cell-mediated neurotoxicity is the lack of clinically relevant models. Accordingly, we developed a rhesus macaque (RM) model of neurotoxicity via adoptive transfer of autologous CD20-specific CAR T cells. Following cyclophosphamide lymphodepletion, CD20 CAR T cells expand to 272 to 4,450 cells/μL after 7 to 8 days and elicit CRS and neurotoxicity. Toxicities are associated with elevated serum IL6, IL8, IL1RA, MIG, and I-TAC levels, and disproportionately high cerebrospinal fluid (CSF) IL6, IL2, GM-CSF, and VEGF levels. During neurotoxicity, both CD20 CAR and non-CAR T cells accumulate in the CSF and in the brain parenchyma. This RM model demonstrates that CAR T cell-mediated neurotoxicity is associated with proinflammatory CSF cytokines and a pan-T cell encephalitis.Significance: We provide the first immunologically relevant, nonhuman primate model of B cell-directed CAR T-cell therapy-mediated CRS and neurotoxicity. We demonstrate CAR and non-CAR T-cell infiltration in the CSF and in the brain during neurotoxicity resulting in pan-encephalitis, accompanied by increased levels of proinflammatory cytokines in the CSF. Cancer Discov; 8(6); 750-63. ©2018 AACR.This article is highlighted in the In This Issue feature, p. 663.
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Affiliation(s)
- Agne Taraseviciute
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
- The Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Victor Tkachev
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
- The Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
| | | | | | - Jessica M Snyder
- Deparment of Comparative Medicine, University of Washington, Seattle, Washington
| | - H Denny Liggitt
- Deparment of Comparative Medicine, University of Washington, Seattle, Washington
| | - David Myerson
- The Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Pathology, University of Washington, Seattle, Washington
| | | | - Audrey Baldessari
- Washington National Primate Research Center, University of Washington, Seattle, Washington
| | - Chris English
- Washington National Primate Research Center, University of Washington, Seattle, Washington
| | - Alison Yu
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Hengqi Zheng
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Scott N Furlan
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
- The Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Daniel J Hunt
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Virginia Hoglund
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Olivia Finney
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Hannah Brakke
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Bruce R Blazar
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Carolina Berger
- The Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Rebecca Gardner
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Leslie S Kean
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.
- The Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Michael C Jensen
- The Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.
- The Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Pediatrics, University of Washington, Seattle, Washington
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38
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Keu KV, Witney TH, Yaghoubi S, Rosenberg J, Kurien A, Magnusson R, Williams J, Habte F, Wagner JR, Forman S, Brown C, Allen-Auerbach M, Czernin J, Tang W, Jensen MC, Badie B, Gambhir SS. Reporter gene imaging of targeted T cell immunotherapy in recurrent glioma. Sci Transl Med 2018; 9. [PMID: 28100832 DOI: 10.1126/scitranslmed.aag2196] [Citation(s) in RCA: 228] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 11/14/2016] [Indexed: 12/12/2022]
Abstract
High-grade gliomas are aggressive cancers that often become rapidly fatal. Immunotherapy using CD8+ cytotoxic T lymphocytes (CTLs), engineered to express both herpes simplex virus type 1 thymidine kinase (HSV1-TK) and interleukin-13 (IL-13) zetakine chimeric antigen receptor (CAR), is a treatment strategy with considerable potential. To optimize this and related immunotherapies, it would be helpful to monitor CTL viability and trafficking to glioma cells. We show that noninvasive positron emission tomography (PET) imaging with 9-[4-[18F]fluoro-3-(hydroxymethyl)butyl]guanine ([18F]FHBG) can track HSV1-tk reporter gene expression present in CAR-engineered CTLs. [18F]FHBG imaging was safe and enabled the longitudinal imaging of T cells stably transfected with a PET reporter gene in patients. Further optimization of this imaging approach for monitoring in vivo cell trafficking should greatly benefit various cell-based therapies for cancer.
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Affiliation(s)
- Khun Visith Keu
- Department of Radiology, Molecular Imaging Program, Stanford University, Palo Alto, CA, 94305, United States.,Division of Nuclear Medicine, Hôpital de la Cité-de-la-Santé de Laval, QC, H7M 3L9, Canada
| | - Timothy H Witney
- Department of Radiology, Molecular Imaging Program, Stanford University, Palo Alto, CA, 94305, United States.,Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, WC1E 6DD, UK
| | - Shahriar Yaghoubi
- Department of Radiology, Molecular Imaging Program, Stanford University, Palo Alto, CA, 94305, United States
| | - Jarrett Rosenberg
- Department of Radiology, Molecular Imaging Program, Stanford University, Palo Alto, CA, 94305, United States
| | - Anita Kurien
- Neurosurgery, City of Hope, Duarte, CA, 91010, United States
| | | | - John Williams
- Molecular & Medical Pharmacology, UCLA, Los Angeles, CA, 90095, United States
| | - Frezghi Habte
- Department of Radiology, Molecular Imaging Program, Stanford University, Palo Alto, CA, 94305, United States
| | - Jamie R Wagner
- Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, 91010, United States
| | - Stephen Forman
- Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, 91010, United States
| | - Christine Brown
- Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, 91010, United States
| | | | - Johannes Czernin
- Molecular & Medical Pharmacology, UCLA, Los Angeles, CA, 90095, United States
| | - Winson Tang
- Sangamo BioSciences Inc, Richmond, CA 94804, United States
| | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, 98145, United States
| | - Behnam Badie
- Neurosurgery, City of Hope, Duarte, CA, 91010, United States
| | - Sanjiv S Gambhir
- Department of Radiology, Molecular Imaging Program, Stanford University, Palo Alto, CA, 94305, United States.,Department of Bioengineering, Department of Materials Science & Engineering, Bio-X, Stanford University, Palo Alto, CA, 94305, United States
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Lee SY, Olsen P, Lee DH, Kenoyer AL, Budde LE, O’Steen S, Green DJ, Heimfeld S, Jensen MC, Riddell SR, Press OW, Till BG. Preclinical Optimization of a CD20-specific Chimeric Antigen Receptor Vector and Culture Conditions. J Immunother 2018; 41:19-31. [PMID: 29176334 PMCID: PMC5759780 DOI: 10.1097/cji.0000000000000199] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chimeric antigen receptor (CAR)-based adoptive T-cell therapy is a highly promising treatment for lymphoid malignancies, and CD20 is an ideal target antigen. We previously developed a lentiviral construct encoding a third generation CD20-targeted CAR but identified several features that required additional optimization before clinical translation. We describe here several improvements, including replacement of the immunogenic murine antigen-binding moiety with a fully human domain, streamlining the transgene insert to enhance lentiviral titers, modifications to the extracellular IgG spacer that abrogate nonspecific activation resulting from binding to Fc receptors, and evaluation of CD28, 4-1BB, or CD28 and 4-1BB costimulatory domains. We also found that restimulation of CAR T cells with an irradiated CD20 cell line boosted cell growth, increased the fraction of CAR-expressing cells, and preserved in vivo function despite leading to a reduced capacity for cytokine secretion in vitro. We also found that cryopreservation of CAR T cells did not affect immunophenotype or in vivo antitumor activity compared with fresh cells. These optimization steps resulted in significant improvement in antitumor activity in mouse models, resulting in eradication of established systemic lymphoma tumors in 75% of mice with a single infusion of CAR T cells, and prolonged in vivo persistence of modified cells. These results provide the basis for clinical testing of a lentiviral construct encoding a fully human CD20-targeted CAR with CD28 and 4-1BB costimulatory domains and truncated CD19 (tCD19) transduction marker.
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MESH Headings
- Animals
- Antigens, CD19/pharmacology
- Antigens, CD20/immunology
- CD28 Antigens/genetics
- Cell Culture Techniques
- Cells, Cultured
- Cytotoxicity, Immunologic
- Drug Evaluation, Preclinical
- Female
- Genetic Engineering
- Humans
- Immunotherapy, Adoptive/methods
- Lymphocyte Activation
- Lymphoma/immunology
- Lymphoma/therapy
- Male
- Mice
- Mice, SCID
- Neoplasms, Experimental
- Receptors, Antigen, T-Cell/genetics
- Recombinant Fusion Proteins
- T-Lymphocytes/physiology
- T-Lymphocytes/transplantation
- Tumor Necrosis Factor Receptor Superfamily, Member 9/genetics
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Sang Yun Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Philip Olsen
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Dong Hoon Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Aimee L. Kenoyer
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Shyril O’Steen
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Damian J. Green
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Division of Medical Oncology, University of Washington School of Medicine, Seattle, WA
| | - Shelly Heimfeld
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Michael C. Jensen
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Seattle Children’s Research Institute, Seattle, WA
| | - Stanley R. Riddell
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Division of Medical Oncology, University of Washington School of Medicine, Seattle, WA
| | - Oliver W. Press
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Division of Medical Oncology, University of Washington School of Medicine, Seattle, WA
| | - Brian G. Till
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Division of Medical Oncology, University of Washington School of Medicine, Seattle, WA
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Zah E, Lin MY, Silva-Benedict A, Jensen MC, Chen YY. ADDENDUM: T Cells Expressing CD19/CD20 Bispecific Chimeric Antigen Receptors Prevent Antigen Escape by Malignant B Cells. Cancer Immunol Res 2017; 4:639-41. [PMID: 27371639 DOI: 10.1158/2326-6066.cir-16-0108] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Abstract
T cells expressing chimeric antigen receptors (CARs) specific for the B-cell marker CD19 have shown impressive results in the treatment of B-cell malignancies. However, multiple clinical trials have also demonstrated the vulnerability of single-input CD19 CAR-T cell therapy to antigen escape, in which patients relapse with the emergence of CD19 tumor cells. Here, we report on the rational design and systematic optimization of bispecific CAR-T cells that trigger robust cytotoxicity against target cells expressing either CD19 or CD20. We demonstrate that optimized bi-specific CARs can rapidly eliminate large, engrafted tumors in vivo. We further demonstrate the bi-specific CAR-T cells ability to prevent tumor escape while single-input CD19 CAR-T cells succumb to the selective expansion of CD19 mutant cells, which are shown to arise spontaneously in engrafted mice. The CD19-OR-CD20 CAR is fully compatible with existing T-cell manufacturing procedures and implementable by current clinical protocols. These results present an effective solution to the challenge of antigen escape in CD19 CAR T-cell therapy, and they highlight the utility of structure-based rational design in the development of receptors with higher-level complexity.
Citation Format: Eugenia Zah, Meng-Yin Lin, Michael C. Jensen, Anne Silva-Benedict, Yvonne Y. Chen. Combating antigen escape with CD19/CD20 bispecific CAR-T cell therapy. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2016 Oct 20-23; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2017;5(3 Suppl):Abstract nr IA12.
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Affiliation(s)
- Eugenia Zah
- 1University of California, Los Angeles, Los Angeles, CA,
| | - Meng-Yin Lin
- 1University of California, Los Angeles, Los Angeles, CA,
| | | | | | - Yvonne Y. Chen
- 1University of California, Los Angeles, Los Angeles, CA,
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Brown CE, Alizadeh D, Starr R, Weng L, Wagner JR, Naranjo A, Ostberg JR, Blanchard MS, Kilpatrick J, Simpson J, Kurien A, Priceman SJ, Wang X, Harshbarger TL, D'Apuzzo M, Ressler JA, Jensen MC, Barish ME, Chen M, Portnow J, Forman SJ, Badie B. Regression of Glioblastoma after Chimeric Antigen Receptor T-Cell Therapy. N Engl J Med 2016; 375:2561-9. [PMID: 28029927 PMCID: PMC5390684 DOI: 10.1056/nejmoa1610497] [Citation(s) in RCA: 1156] [Impact Index Per Article: 144.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A patient with recurrent multifocal glioblastoma received chimeric antigen receptor (CAR)-engineered T cells targeting the tumor-associated antigen interleukin-13 receptor alpha 2 (IL13Rα2). Multiple infusions of CAR T cells were administered over 220 days through two intracranial delivery routes - infusions into the resected tumor cavity followed by infusions into the ventricular system. Intracranial infusions of IL13Rα2-targeted CAR T cells were not associated with any toxic effects of grade 3 or higher. After CAR T-cell treatment, regression of all intracranial and spinal tumors was observed, along with corresponding increases in levels of cytokines and immune cells in the cerebrospinal fluid. This clinical response continued for 7.5 months after the initiation of CAR T-cell therapy. (Funded by Gateway for Cancer Research and others; ClinicalTrials.gov number, NCT02208362 .).
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Affiliation(s)
- Christine E Brown
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Darya Alizadeh
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Renate Starr
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Lihong Weng
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Jamie R Wagner
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Araceli Naranjo
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Julie R Ostberg
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - M Suzette Blanchard
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Julie Kilpatrick
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Jennifer Simpson
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Anita Kurien
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Saul J Priceman
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Xiuli Wang
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Todd L Harshbarger
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Massimo D'Apuzzo
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Julie A Ressler
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Michael C Jensen
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Michael E Barish
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Mike Chen
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Jana Portnow
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Stephen J Forman
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
| | - Behnam Badie
- From the Department of Hematology and Hematopoietic Cell Transplantation, T Cell Therapeutics Research Laboratory (C.E.B., D.A., R.S., L.W., J.R.W., A.N., J.R.O., A.K., S.J.P., X.W., S.J.F.), and the Departments of Information Sciences (M.S.B.), Clinical Research (J.K., J.S.), Neurosurgery (T.L.H., M.C., B.B.), Pathology (M.D.), Diagnostic Radiology (J.A.R.), Developmental and Stem Cell Biology (M.E.B.), and Medical Oncology and Therapeutics Research (J.P.), City of Hope Beckman Research Institute and Medical Center, Duarte, CA; and the Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle (M.C.J.)
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Paszkiewicz PJ, Fräßle SP, Srivastava S, Sommermeyer D, Hudecek M, Drexler I, Sadelain M, Liu L, Jensen MC, Riddell SR, Busch DH. Targeted antibody-mediated depletion of murine CD19 CAR T cells permanently reverses B cell aplasia. J Clin Invest 2016; 126:4262-4272. [PMID: 27760047 DOI: 10.1172/jci84813] [Citation(s) in RCA: 201] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 09/08/2016] [Indexed: 12/12/2022] Open
Abstract
The adoptive transfer of T cells that have been genetically modified to express a CD19-specific chimeric antigen receptor (CAR) is effective for treating human B cell malignancies. However, the persistence of functional CD19 CAR T cells causes sustained depletion of endogenous CD19+ B cells and hypogammaglobulinemia. Thus, there is a need for a mechanism to ablate transferred T cells after tumor eradication is complete to allow recovery of normal B cells. Previously, we developed a truncated version of the epidermal growth factor receptor (EGFRt) that is coexpressed with the CAR on the T cell surface. Here, we show that targeting EGFRt with the IgG1 monoclonal antibody cetuximab eliminates CD19 CAR T cells both early and late after adoptive transfer in mice, resulting in complete and permanent recovery of normal functional B cells, without tumor relapse. EGFRt can be incorporated into many clinical applications to regulate the survival of gene-engineered cells. These results support the concept that EGFRt represents a promising approach to improve safety of cell-based therapies.
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44
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Gwiazda KS, Grier AE, Sahni J, Burleigh SM, Martin U, Yang JG, Popp NA, Krutein MC, Khan IF, Jacoby K, Jensen MC, Rawlings DJ, Scharenberg AM. High Efficiency CRISPR/Cas9-mediated Gene Editing in Primary Human T-cells Using Mutant Adenoviral E4orf6/E1b55k "Helper" Proteins. Mol Ther 2016; 24:1570-80. [PMID: 27203437 PMCID: PMC5113096 DOI: 10.1038/mt.2016.105] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 04/20/2016] [Indexed: 12/12/2022] Open
Abstract
Many future therapeutic applications of Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/Cas9 and related RNA-guided nucleases are likely to require their use to promote gene targeting, thus necessitating development of methods that provide for delivery of three components-Cas9, guide RNAs and recombination templates-to primary cells rendered proficient for homology-directed repair. Here, we demonstrate an electroporation/transduction codelivery method that utilizes mRNA to express both Cas9 and mutant adenoviral E4orf6 and E1b55k helper proteins in association with adeno-associated virus (AAV) vectors expressing guide RNAs and recombination templates. By transiently enhancing target cell permissiveness to AAV transduction and gene editing efficiency, this novel approach promotes efficient gene disruption and/or gene targeting at multiple loci in primary human T-cells, illustrating its broad potential for application in translational gene editing.
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Affiliation(s)
- Kamila S Gwiazda
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Alexandra E Grier
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
- Department of Immunology, University of Washington, Seattle, Washington, USA
| | - Jaya Sahni
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Stephen M Burleigh
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Unja Martin
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Julia G Yang
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Nicholas A Popp
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Michelle C Krutein
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Iram F Khan
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Kyle Jacoby
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - David J Rawlings
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
- Department of Immunology, University of Washington, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Washington, USA
| | - Andrew M Scharenberg
- Program for Cell and Gene Therapy, Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
- Department of Immunology, University of Washington, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Washington, USA
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45
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Künkele A, Taraseviciute A, Finn LS, Johnson AJ, Berger C, Finney O, Chang CA, Rolczynski LS, Brown C, Mgebroff S, Berger M, Park JR, Jensen MC. Preclinical Assessment of CD171-Directed CAR T-cell Adoptive Therapy for Childhood Neuroblastoma: CE7 Epitope Target Safety and Product Manufacturing Feasibility. Clin Cancer Res 2016; 23:466-477. [PMID: 27390347 DOI: 10.1158/1078-0432.ccr-16-0354] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 06/13/2016] [Accepted: 06/28/2016] [Indexed: 11/16/2022]
Abstract
PURPOSE The identification and vetting of cell surface tumor-restricted epitopes for chimeric antigen receptor (CAR)-redirected T-cell immunotherapy is the subject of intensive investigation. We have focused on CD171 (L1-CAM), an abundant cell surface molecule on neuroblastomas and, specifically, on the glycosylation-dependent tumor-specific epitope recognized by the CE7 monoclonal antibody. EXPERIMENTAL DESIGN CD171 expression was assessed by IHC using CE7 mAb in tumor microarrays of primary, metastatic, and recurrent neuroblastoma, as well as human and rhesus macaque tissue arrays. The safety of targeting the CE7 epitope of CD171 with CE7-CAR T cells was evaluated in a preclinical rhesus macaque trial on the basis of CD171 homology and CE7 cross reactivity. The feasibility of generating bioactive CAR T cells from heavily pretreated pediatric patients with recurrent/refractory disease was assessed. RESULTS CD171 is uniformly and abundantly expressed by neuroblastoma tumor specimens obtained at diagnoses and relapse independent of patient clinical risk group. CD171 expression in normal tissues is similar in humans and rhesus macaques. Infusion of up to 1 × 108/kg CE7-CAR+ CTLs in rhesus macaques revealed no signs of specific on-target off-tumor toxicity. Manufacturing of lentivirally transduced CD4+ and CD8+ CE7-CAR T-cell products under GMP was successful in 4 out of 5 consecutively enrolled neuroblastoma patients in a phase I study. All four CE7-CAR T-cell products demonstrated in vitro and in vivo antitumor activity. CONCLUSIONS Our preclinical assessment of the CE7 epitope on CD171 supports its utility and safety as a CAR T-cell target for neuroblastoma immunotherapy. Clin Cancer Res; 23(2); 466-77. ©2016 AACR.
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Affiliation(s)
- Annette Künkele
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Agne Taraseviciute
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington.,Fred Hutchinson Cancer Research Center, Seattle, Washington.,Seattle Children's Hospital, Department of Pediatrics, University of Washington, Seattle, Washington
| | - Laura S Finn
- Seattle Children's Hospital, Department of Pathology, University of Washington, Seattle, Washington
| | - Adam J Johnson
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Carolina Berger
- Fred Hutchinson Cancer Research Center, Seattle, Washington.,Department of Medicine, University of Washington, Seattle, Washington
| | - Olivia Finney
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Cindy A Chang
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Lisa S Rolczynski
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Christopher Brown
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Stephanie Mgebroff
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington
| | - Michael Berger
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Julie R Park
- Seattle Children's Hospital, Department of Pediatrics, University of Washington, Seattle, Washington
| | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington. .,Seattle Children's Hospital, Department of Pediatrics, University of Washington, Seattle, Washington.,University of Washington, Department of Bioengineering, Seattle, Washington
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46
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Brown CE, Starr R, Weng L, Alizadeh D, Wagner JR, Kilpatrick J, Harshbarger TL, D'Apuzzo M, Ressler JA, Jensen MC, Portnow J, Barish ME, Forman SJ, Badie B. 247. Phase I Study of Second Generation Chimeric Antigen Receptor-Engineered T Cells Targeting IL13Rα2 for the Treatment of Glioblastoma. Mol Ther 2016. [DOI: 10.1016/s1525-0016(16)33056-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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47
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Turtle CJ, Hanafi LA, Berger C, Gooley TA, Cherian S, Hudecek M, Sommermeyer D, Melville K, Pender B, Budiarto TM, Robinson E, Steevens NN, Chaney C, Soma L, Chen X, Yeung C, Wood B, Li D, Cao J, Heimfeld S, Jensen MC, Riddell SR, Maloney DG. CD19 CAR-T cells of defined CD4+:CD8+ composition in adult B cell ALL patients. J Clin Invest 2016; 126:2123-38. [PMID: 27111235 DOI: 10.1172/jci85309] [Citation(s) in RCA: 1438] [Impact Index Per Article: 179.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/08/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND T cells that have been modified to express a CD19-specific chimeric antigen receptor (CAR) have antitumor activity in B cell malignancies; however, identification of the factors that determine toxicity and efficacy of these T cells has been challenging in prior studies in which phenotypically heterogeneous CAR-T cell products were prepared from unselected T cells. METHODS We conducted a clinical trial to evaluate CD19 CAR-T cells that were manufactured from defined CD4+ and CD8+ T cell subsets and administered in a defined CD4+:CD8+ composition to adults with B cell acute lymphoblastic leukemia after lymphodepletion chemotherapy. RESULTS The defined composition product was remarkably potent, as 27 of 29 patients (93%) achieved BM remission, as determined by flow cytometry. We established that high CAR-T cell doses and tumor burden increase the risks of severe cytokine release syndrome and neurotoxicity. Moreover, we identified serum biomarkers that allow testing of early intervention strategies in patients at the highest risk of toxicity. Risk-stratified CAR-T cell dosing based on BM disease burden decreased toxicity. CD8+ T cell-mediated anti-CAR transgene product immune responses developed after CAR-T cell infusion in some patients, limited CAR-T cell persistence, and increased relapse risk. Addition of fludarabine to the lymphodepletion regimen improved CAR-T cell persistence and disease-free survival. CONCLUSION Immunotherapy with a CAR-T cell product of defined composition enabled identification of factors that correlated with CAR-T cell expansion, persistence, and toxicity and facilitated design of lymphodepletion and CAR-T cell dosing strategies that mitigated toxicity and improved disease-free survival. TRIAL REGISTRATION ClinicalTrials.gov NCT01865617. FUNDING R01-CA136551; Life Science Development Fund; Juno Therapeutics; Bezos Family Foundation.
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48
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Rufener GA, Press OW, Olsen P, Lee SY, Jensen MC, Gopal AK, Pender B, Budde LE, Rossow JK, Green DJ, Maloney DG, Riddell SR, Till BG. Preserved Activity of CD20-Specific Chimeric Antigen Receptor–Expressing T Cells in the Presence of Rituximab. Cancer Immunol Res 2016; 4:509-19. [DOI: 10.1158/2326-6066.cir-15-0276] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/09/2016] [Indexed: 11/16/2022]
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49
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Grier AE, Burleigh S, Sahni J, Clough CA, Cardot V, Choe DC, Krutein MC, Rawlings DJ, Jensen MC, Scharenberg AM, Jacoby K. pEVL: A Linear Plasmid for Generating mRNA IVT Templates With Extended Encoded Poly(A) Sequences. Mol Ther Nucleic Acids 2016; 5:e306. [PMID: 27093168 PMCID: PMC5014522 DOI: 10.1038/mtna.2016.21] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 03/01/2016] [Indexed: 11/23/2022]
Abstract
Increasing demand for large-scale synthesis of in vitro transcribed (IVT) mRNA is being driven by the increasing use of mRNA for transient gene expression in cell engineering and therapeutic applications. An important determinant of IVT mRNA potency is the 3′ polyadenosine (poly(A)) tail, the length of which correlates with translational efficiency. However, present methods for generation of IVT mRNA rely on templates derived from circular plasmids or PCR products, in which homopolymeric tracts are unstable, thus limiting encoded poly(A) tail lengths to ~120 base pairs (bp). Here, we have developed a novel method for generation of extended poly(A) tracts using a previously described linear plasmid system, pJazz. We find that linear plasmids can successfully propagate poly(A) tracts up to ~500 bp in length for IVT mRNA production. We then modified pJazz by removing extraneous restriction sites, adding a T7 promoter sequence upstream from an extended multiple cloning site, and adding a unique type-IIS restriction site downstream from the encoded poly(A) tract to facilitate generation of IVT mRNA with precisely defined encoded poly(A) tracts and 3′ termini. The resulting plasmid, designated pEVL, can be used to generate IVT mRNA with consistent defined lengths and terminal residue(s).
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Affiliation(s)
- Alexandra E Grier
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA.,Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Immunology Department, University of Washington School of Medicine, Seattle, Washington, USA
| | - Stephen Burleigh
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Jaya Sahni
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Courtnee A Clough
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Victoire Cardot
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Dongwook C Choe
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Michelle C Krutein
- Pathology Department, University of Washington School of Medicine, Seattle, Washington, USA
| | - David J Rawlings
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA.,Immunology Department, University of Washington School of Medicine, Seattle, Washington, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.,Bioengineering Department, University of Washington School of Medicine, Seattle, Washington, USA.,Immunology Program, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Andrew M Scharenberg
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA.,Immunology Department, University of Washington School of Medicine, Seattle, Washington, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Kyle Jacoby
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Washington, USA
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Zah E, Lin MY, Silva-Benedict A, Jensen MC, Chen YY. T Cells Expressing CD19/CD20 Bispecific Chimeric Antigen Receptors Prevent Antigen Escape by Malignant B Cells. Cancer Immunol Res 2016; 4:498-508. [PMID: 27059623 DOI: 10.1158/2326-6066.cir-15-0231] [Citation(s) in RCA: 388] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 03/06/2016] [Indexed: 01/29/2023]
Abstract
The adoptive transfer of T cells expressing anti-CD19 chimeric antigen receptors (CARs) has shown remarkable curative potential against advanced B-cell malignancies, but multiple trials have also reported patient relapses due to the emergence of CD19-negative leukemic cells. Here, we report the design and optimization of single-chain, bispecific CARs that trigger robust cytotoxicity against target cells expressing either CD19 or CD20, two clinically validated targets for B-cell malignancies. We determined the structural parameters required for efficient dual-antigen recognition, and we demonstrate that optimized bispecific CARs can control both wild-type B-cell lymphoma and CD19(-) mutants with equal efficiency in vivo To our knowledge, this is the first bispecific CAR capable of preventing antigen escape by performing true OR-gate signal computation on a clinically relevant pair of tumor-associated antigens. The CD19-OR-CD20 CAR is fully compatible with existing T-cell manufacturing procedures and implementable by current clinical protocols. These results present an effective solution to the challenge of antigen escape in CD19 CAR T-cell therapy, and they highlight the utility of structure-based rational design in the development of receptors with higher-level complexity. Cancer Immunol Res; 4(6); 498-508. ©2016 AACR
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Affiliation(s)
- Eugenia Zah
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California
| | - Meng-Yin Lin
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California
| | - Anne Silva-Benedict
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington. Department of Oncology and Hematology, St. Luke's Regional Cancer Center, Duluth, Minnesota
| | - Michael C Jensen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington. Division of Pediatric Hematology-Oncology, University of Washington School of Medicine, Seattle, Washington. Program in Immunology, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Yvonne Y Chen
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California.
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