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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 SES, 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] [MESH Headings] [Grants] [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]
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.
| | - 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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