Journal
JOURNAL OF CLINICAL INVESTIGATION
Volume 132, Issue 12, Pages -Publisher
AMER SOC CLINICAL INVESTIGATION INC
DOI: 10.1172/JCI150807
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Funding
- European Union [667980, 754658]
- Innovative Medicines Initiative [945393]
- Italian Ministry of Health [GR-2013-02359212]
- Alliance against Cancer, Ricerca Corrente CAR T project [RCR-2019-23669115]
- Italian Association for Cancer Research [AIRC-IG-18458]
- Italian Ministry of University and Research [MIUR-2015NZWSEC_001]
- Vita-Salute San Raffaele University, doctoral program in Basic and Applied Immunology and Oncology (BAIO), Milan
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This study investigated the efficacy and safety profiles of CAR T cell products generated from preselected naive/stem memory T cells (TN/SCM). The results showed that CAR TN/SCM cells exhibited stronger antitumor activity and were able to prevent leukemia relapse. Furthermore, CAR TN/SCM cells had a lower risk of inducing severe cytokine release syndrome, indicating a higher therapeutic index.
Chimeric antigen receptor (CAR) T cell expansion and persistence represent key factors to achieve complete responses and prevent relapses. These features are typical of early memory T cells, which can be highly enriched through optimized manufacturing protocols. Here, we investigated the efficacy and safety profiles of CAR T cell products generated from preselected naive/stem memory T cells (TN/SCM), as compared with unselected T cells (TBULK). Notwithstanding their reduced effector signature in vitro, limiting CAR TN/SCM doses showed superior antitumor activity and the unique ability to counteract leukemia rechallenge in hematopoietic stem/precursor cell???humanized mice, featuring increased expansion rates and persistence together with an ameliorated exhaustion and memory phenotype. Most relevantly, CAR TN/SCM proved to be intrinsically less prone to inducing severe cytokine release syndrome, independently of the costimulatory endodomain employed. This safer profile was associated with milder T cell activation, which translated into reduced monocyte activation and cytokine release. These data suggest that CAR TN/SCM are endowed with a wider therapeutic index compared with CAR TBULK.
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