51
|
Gao Q, Dong X, Xu Q, Zhu L, Wang F, Hou Y, Chao C. Therapeutic potential of CRISPR/Cas9 gene editing in engineered T-cell therapy. Cancer Med 2019; 8:4254-4264. [PMID: 31199589 PMCID: PMC6675705 DOI: 10.1002/cam4.2257] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/19/2019] [Accepted: 05/07/2019] [Indexed: 12/27/2022] Open
Abstract
Cancer patients have been treated with various types of therapies, including conventional strategies like chemo-, radio-, and targeted therapy, as well as immunotherapy like checkpoint inhibitors, vaccine and cell therapy etc. Among the therapeutic alternatives, T-cell therapy like CAR-T (Chimeric Antigen Receptor Engineered T cell) and TCR-T (T Cell Receptor Engineered T cell), has emerged as the most promising therapeutics due to its impressive clinical efficacy. However, there are many challenges and obstacles, such as immunosuppressive tumor microenvironment, manufacturing complexity, and poor infiltration of engrafted cells, etc still, need to be overcome for further treatment with different forms of cancer. Recently, the antitumor activities of CAR-T and TCR-T cells have shown great improvement with the utilization of CRISPR/Cas9 gene editing technology. Thus, the genome editing system could be a powerful genetic tool to use for manipulating T cells and enhancing the efficacy of cell immunotherapy. This review focuses on pros and cons of various gene delivery methods, challenges, and safety issues of CRISPR/Cas9 gene editing application in T-cell-based immunotherapy.
Collapse
Affiliation(s)
- Qianqian Gao
- BGI‐Shenzhen, Beishan Industrial ZoneShenzhenChina
- Shenzhen Key Laboratory of GenomicsBeishan Industrial ZoneShenzhenChina
- Guangdong Enterprise Key Laboratory of Human Disease GenomicsBeishan Industrial ZoneShenzhenChina
| | - Xuan Dong
- BGI‐Shenzhen, Beishan Industrial ZoneShenzhenChina
- Shenzhen Key Laboratory of GenomicsBeishan Industrial ZoneShenzhenChina
- Guangdong Enterprise Key Laboratory of Human Disease GenomicsBeishan Industrial ZoneShenzhenChina
| | - Qumiao Xu
- BGI‐Shenzhen, Beishan Industrial ZoneShenzhenChina
- Shenzhen Key Laboratory of GenomicsBeishan Industrial ZoneShenzhenChina
- Guangdong Enterprise Key Laboratory of Human Disease GenomicsBeishan Industrial ZoneShenzhenChina
| | - Linnan Zhu
- BGI‐Shenzhen, Beishan Industrial ZoneShenzhenChina
- Shenzhen Key Laboratory of GenomicsBeishan Industrial ZoneShenzhenChina
- Guangdong Enterprise Key Laboratory of Human Disease GenomicsBeishan Industrial ZoneShenzhenChina
| | - Fei Wang
- BGI‐Shenzhen, Beishan Industrial ZoneShenzhenChina
- Shenzhen Key Laboratory of GenomicsBeishan Industrial ZoneShenzhenChina
- Guangdong Enterprise Key Laboratory of Human Disease GenomicsBeishan Industrial ZoneShenzhenChina
- BGI Education CenterUniversity of Chinese Academy of Sciences, Beishan Industrial ZoneShenzhenChina
| | - Yong Hou
- BGI‐Shenzhen, Beishan Industrial ZoneShenzhenChina
- Shenzhen Key Laboratory of GenomicsBeishan Industrial ZoneShenzhenChina
- Guangdong Enterprise Key Laboratory of Human Disease GenomicsBeishan Industrial ZoneShenzhenChina
| | - Cheng‐chi Chao
- BGI‐Shenzhen, Beishan Industrial ZoneShenzhenChina
- Shenzhen Key Laboratory of GenomicsBeishan Industrial ZoneShenzhenChina
- Guangdong Enterprise Key Laboratory of Human Disease GenomicsBeishan Industrial ZoneShenzhenChina
- AbVision, IncMilpitasCalifornia
| |
Collapse
|
52
|
Arndt C, Bachmann M, Bergmann R, Berndt N, Feldmann A, Koristka S. Theranostic CAR T cell targeting: A brief review. J Labelled Comp Radiopharm 2019; 62:533-540. [PMID: 30889625 DOI: 10.1002/jlcr.3727] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/13/2019] [Indexed: 12/21/2022]
Abstract
More than hundred years ago, Paul Ehrlich postulated that our immune system should be able to recognize tumor cells. Just recently, the development of check point inhibitors, bispecific antibodies, and T cells genetically modified to express chimeric antigen receptors (CARs) underlines the true power of our immune system. T cells genetically modified with CARs can lead to complete remission of malignant hematologic diseases. However, they can also cause life-threatening side effects. In case of cytokine release syndrome, tumor lysis syndrome, or deadly side effects on the central nervous system, an emergency shut down of CAR T cells is needed. Targeting of tumor-associated antigens that are also expressed on vital tissues require a possibility to repeatedly switch the activity of CAR T cells on and off on demand and to follow the treatment by imaging. Theranostic, modular CARs such as the UniCAR system may help to overcome these problems.
Collapse
Affiliation(s)
- Claudia Arndt
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Michael Bachmann
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,German Cancer Consortium (DKTK), partner site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany.,UniversityCancerCenter (UCC) Dresden, Tumor Immunology, 'Carl Gustav Carus' Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), partner site Dresden, Dresden, Germany
| | - Ralf Bergmann
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Nicole Berndt
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,German Cancer Consortium (DKTK), partner site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anja Feldmann
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Stefanie Koristka
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| |
Collapse
|
53
|
Microbiota: Overview and Implication in Immunotherapy-Based Cancer Treatments. Int J Mol Sci 2019; 20:ijms20112699. [PMID: 31159348 PMCID: PMC6600175 DOI: 10.3390/ijms20112699] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/17/2019] [Accepted: 05/26/2019] [Indexed: 12/12/2022] Open
Abstract
During the last few years, the gut microbiota has gained increasing attention as a consequence of its emerging role as a modulator of the immune system. With the advent of the era of checkpoint inhibitors immunotherapy and adoptive cell transfer (ACT) in oncology, these findings became of primary relevance in light of experimental data that suggested the microbiota involvement as a plausible predictor of a good or poor response. These remarks justify the efforts to pinpoint the specific actions of the microbiota and to identify new strategies to favorably edit its composition.
Collapse
|
54
|
The UniCAR system: A modular CAR T cell approach to improve the safety of CAR T cells. Immunol Lett 2019; 211:13-22. [PMID: 31091431 DOI: 10.1016/j.imlet.2019.05.003] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 12/19/2022]
Abstract
The idea to eliminate tumor cells via our own immune system is more than a hundred years old. However, a real break through came first with the development of check point inhibitors, bispecific antibodies (bsAbs) and T cells genetically modified to express Chimeric Antigen Receptors (CARs). Eventhough the clinical application of T cells equipped with CARs can lead to a complete remission, unfortunately, their application can also cause severe or even life threatening side effects as their activity can no more be adjusted once given to the patient. For targeting of tumor cells expressing tumor associated antigens (TAAs) which are not limited to tumor cells but also accessible on healthy tissues CAR T cells should not be permanently in a killing mode but be equipped with some kind of a switch whereby the activity of CAR T cells can reversely be turned "on and off ". Moreover, in case of cytokine release syndrome (CRS), tumor lysis syndrome (TLS), or other deadly side effects the possibility of an emergency shut down of the CAR T cell activity should exist. Modular CAR variants such as the UniCAR system may fulfill these requirements.
Collapse
|
55
|
Salas-Mckee J, Kong W, Gladney WL, Jadlowsky JK, Plesa G, Davis MM, Fraietta JA. CRISPR/Cas9-based genome editing in the era of CAR T cell immunotherapy. Hum Vaccin Immunother 2019; 15:1126-1132. [PMID: 30735463 DOI: 10.1080/21645515.2019.1571893] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The advent of engineered T cells as a form of immunotherapy marks the beginning of a new era in medicine, providing a transformative way to combat complex diseases such as cancer. Following FDA approval of CAR T cells directed against the CD19 protein for the treatment of acute lymphoblastic leukemia and diffuse large B cell lymphoma, CAR T cells are poised to enter mainstream oncology. Despite this success, a number of patients are unable to receive this therapy due to inadequate T cell numbers or rapid disease progression. Furthermore, lack of response to CAR T cell treatment is due in some cases to intrinsic autologous T cell defects and/or the inability of these cells to function optimally in a strongly immunosuppressive tumor microenvironment. We describe recent efforts to overcome these limitations using CRISPR/Cas9 technology, with the goal of enhancing potency and increasing the availability of CAR-based therapies. We further discuss issues related to the efficiency/scalability of CRISPR/Cas9-mediated genome editing in CAR T cells and safety considerations. By combining the tools of synthetic biology such as CARs and CRISPR/Cas9, we have an unprecedented opportunity to optimally program T cells and improve adoptive immunotherapy for most, if not all future patients.
Collapse
Affiliation(s)
- January Salas-Mckee
- a Center for Cellular Immunotherapies, Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA , USA
| | - Weimin Kong
- a Center for Cellular Immunotherapies, Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA , USA
| | - Whitney L Gladney
- a Center for Cellular Immunotherapies, Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA , USA
| | - Julie K Jadlowsky
- a Center for Cellular Immunotherapies, Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA , USA
| | - Gabriela Plesa
- a Center for Cellular Immunotherapies, Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA , USA
| | - Megan M Davis
- a Center for Cellular Immunotherapies, Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA , USA.,b Department of Pathology and Laboratory Medicine, Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA
| | - Joseph A Fraietta
- a Center for Cellular Immunotherapies, Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA , USA.,b Department of Pathology and Laboratory Medicine, Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA.,c Parker Institute for Cancer Immunotherapy , University of Pennsylvania , Philadelphia , PA , USA.,d Department of Microbiology, Perelman School of Medicine , University of Pennsylvania , Philadelphia, PA , USA
| |
Collapse
|
56
|
Souza-Fonseca-Guimaraes F, Cursons J, Huntington ND. The Emergence of Natural Killer Cells as a Major Target in Cancer Immunotherapy. Trends Immunol 2019; 40:142-158. [PMID: 30639050 DOI: 10.1016/j.it.2018.12.003] [Citation(s) in RCA: 196] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 12/14/2022]
Abstract
Immune 'checkpoint' inhibitors can increase the activity of tumor-resident cytotoxic lymphocytes and have revolutionized cancer treatment. Current therapies block inhibitory pathways in tumor-infiltrating CD8+ T cells and recent studies have shown similar programs in other effector populations such as natural killer (NK) cells. NK cells are critical for immunosurveillance, particularly the control of metastatic cells or hematological cancers. However, how NK cells specifically recognize transformed cells and dominant negative feedback pathways, as well as how tumors escape NK cell control, remains undefined. This review summarizes recent advances that have illuminated inhibitory checkpoints in NK cells, some of which are shared with conventional cytotoxic T lymphocytes. It also outlines emerging approaches aimed at unleashing the potential of NK cells in immunotherapy.
Collapse
Affiliation(s)
- Fernando Souza-Fonseca-Guimaraes
- Molecular Immunology Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia; Department of Medical Biology, University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria 3010, Australia.
| | - Joseph Cursons
- Department of Medical Biology, University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria 3010, Australia; Bioinformatics Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia
| | - Nicholas D Huntington
- Molecular Immunology Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia; Department of Medical Biology, University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria 3010, Australia; Biomedicine Discovery Institute and the Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria 3800, Australia.
| |
Collapse
|
57
|
Zhao J, Lin Q, Song Y, Liu D. Universal CARs, universal T cells, and universal CAR T cells. J Hematol Oncol 2018; 11:132. [PMID: 30482221 PMCID: PMC6257951 DOI: 10.1186/s13045-018-0677-2] [Citation(s) in RCA: 187] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/15/2018] [Indexed: 12/11/2022] Open
Abstract
Currently, the two approved T cell products with chimeric antigen receptors (CAR) are from autologous T cells. These CAR T cells approved for clinical use must be generated on a custom-made basis. This case-by-case autologous T cell production platform remains a significant limiting factor for large-scale clinical application due to the costly and lengthy production process. There is also an inherent risk of production failure. The individualized, custom-made autologous CAR T cell production process also posts constriction on the wide application on diverse tumor types. Therefore, universal allogeneic T cells are needed for the preparation of universal CAR T cells that can serve as the “off-the-shelf” ready-to-use therapeutic agents for large-scale clinical applications. Genome-editing technologies including ZFN (zinc finger nuclease), TALEN (transcription activator-like effector nuclease), and CRISPR-Cas9 are being used to generate the universal third-party T cells. In addition, split, universal, and programmable (SUPRA) CARs are being developed to enhance the flexibility and controllability of CAR T cells. The engineered universal T cells and universal CARs are paving the road for a totally new generation of CAR T cells capable of targeting multiple antigens and/ or being delivered to multiple recipients without re-editing of T cells. This may escalate to a new wave of revolution in cancer immunotherapy. This review summarized the latest advances on designs and development of universal CARs, universal T cells, and clinical application of universal CAR T cells.
Collapse
Affiliation(s)
- Juanjuan Zhao
- The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, 127 Dongming Road, Zhengzhou, 450008, China
| | - Quande Lin
- The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, 127 Dongming Road, Zhengzhou, 450008, China
| | - Yongping Song
- The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, 127 Dongming Road, Zhengzhou, 450008, China
| | - Delong Liu
- The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, 127 Dongming Road, Zhengzhou, 450008, China.
| |
Collapse
|