期刊
NEURO-ONCOLOGY
卷 20, 期 4, 页码 506-518出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/neuonc/nox182
关键词
EphA2; glioblastoma; HER2; IL13R alpha 2; universal CAR T-cells
资金
- Childhood Brain Tumor Foundation (CBTF) Astrocytoma Grant
- Alex's Lemonade Stand Pediatric Cancer Foundation (ALSF)
- Alliance for Cancer Gene Therapy (ACGT, Inc) [R01AI067946]
- Stand Up to Cancer-St Baldrick's Pediatric Dream Team Translational Research Grant [SU2C-AACR-DT1113]
- Stand Up to Cancer is a program of the Entertainment Industry Foundation
- NIH [T32HL092332]
- National Institute of General Medical Sciences (NIGMS) [T32GM088129]
Glioblastoma (GBM) is the most common primary malignant brain cancer, and is currently incurable. Chimeric antigen receptor (CAR) T cells have shown promise in GBM treatment. While we have shown that combinatorial targeting of 2 glioma antigens offsets antigen escape and enhances T-cell effector functions, the interpatient variability in surface antigen expression between patients hinders the clinical impact of targeting 2 antigen pairs. This study addresses targeting 3 antigens using a single CAR T-cell product for broader application. We analyzed the surface expression of 3 targetable glioma antigens (human epidermal growth factor receptor 2 [HER2], interleukin-13 receptor subunit alpha-2 [IL13R alpha 2], and ephrin-A2 [EphA2]) in 15 primary GBM samples. Accordingly, we created a trivalent T-cell product armed with 3 CAR molecules specific for these validated targets encoded by a single universal (U) tricistronic transgene (UCAR T cells). Our data showed that co-targeting HER2, IL13R alpha 2, and EphA2 could overcome interpatient variability by a tendency to capture nearly 100% of tumor cells in most tumors tested in this cohort. UCAR T cells made from GBM patients' blood uniformly expressed all 3 CAR molecules with distinct antigen specificity. UCAR T cells mediated robust immune synapses with tumor targets forming more polarized microtubule organizing centers and exhibited improved cytotoxicity and cytokine release over best monospecific and bispecific CAR T cells per patient tumor profile. Lastly, low doses of UCAR T cells controlled established autologous GBM patient derived xenografts (PDXs) and improved survival of treated animals. UCAR T cells can overcome antigenic heterogeneity in GBM and lead to improved treatment outcomes.
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