101
|
Weinkove R, George P, Dasyam N, McLellan AD. Selecting costimulatory domains for chimeric antigen receptors: functional and clinical considerations. Clin Transl Immunology 2019; 8:e1049. [PMID: 31110702 PMCID: PMC6511336 DOI: 10.1002/cti2.1049] [Citation(s) in RCA: 198] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/07/2019] [Accepted: 04/10/2019] [Indexed: 12/11/2022] Open
Abstract
Costimulatory signals are required to achieve robust chimeric antigen receptor (CAR) T cell expansion, function, persistence and antitumor activity. These can be provided by incorporating intracellular signalling domains from one or more T cell costimulatory molecules, such as CD28 or 4-1BB, into the CAR. The selection and positioning of costimulatory domains within a CAR construct influence CAR T cell function and fate, and clinical experience of autologous anti-CD19 CAR T cell therapies suggests that costimulatory domains have differential impacts on CAR T cell kinetics, cytotoxic function and potentially safety profile. The clinical impacts of combining costimulatory domains and of alternative costimulatory domains are not yet clearly established, and may be construct- and disease-specific. The aim of this review is to summarise the function and effect of established and emerging costimulatory domains and their combinations within CAR T cells.
Collapse
Affiliation(s)
- Robert Weinkove
- Cancer Immunotherapy Programme Malaghan Institute of Medical Research Wellington New Zealand.,Wellington Blood & Cancer Centre Capital & Coast District Health Board Wellington New Zealand.,Department of Pathology & Molecular Medicine University of Otago Wellington Wellington New Zealand
| | - Philip George
- Cancer Immunotherapy Programme Malaghan Institute of Medical Research Wellington New Zealand.,Wellington Blood & Cancer Centre Capital & Coast District Health Board Wellington New Zealand
| | - Nathaniel Dasyam
- Cancer Immunotherapy Programme Malaghan Institute of Medical Research Wellington New Zealand
| | - Alexander D McLellan
- Department of Microbiology and Immunology University of Otago Dunedin New Zealand
| |
Collapse
|
102
|
Bezerra ED, Flowers ME, Onstad LE, Chielens D, Radich J, Higano CS. A phase 2 study of alpha interferon for molecularly measurable residual disease in chronic myeloid leukemia after allogeneic hematopoietic cell transplantation. Leuk Lymphoma 2019; 60:2754-2761. [PMID: 31014151 DOI: 10.1080/10428194.2019.1605508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
CML therapy has improved dramatically with the development of tyrosine kinase inhibitors (TKIs). Prior to the TKI era, we conducted two trials of alpha-interferon (IFN) for post-transplant hematologic and cytogenetic relapse. The complete cytogenetic response rate was 33% and 57% respectively. This report describes a third trial in which 40 patients with molecular relapse between 6 and 12 months post-transplant were treated with IFN. The projected cytogenetic relapse at 4.5 years was 12.6% compared with 42% in the historical control group. Although this data may not apply to most patients with CML today due to the availability of multiple TKIs, the effectiveness of short term IFN in post-transplant molecular relapse is supported by long-term treatment-free-survival in 75% of patients after a median follow-up of 15.6 years. This report suggests that alpha-interferon is potentially useful in the rare patient who has post-transplant molecular relapse who does not tolerate, or is resistant to TKIs.
Collapse
Affiliation(s)
- Evandro D Bezerra
- Department of Medicine Division of Oncology, University of Washington, Seattle, WA, USA
| | - Mary E Flowers
- Department of Medicine Division of Oncology, University of Washington, Seattle, WA, USA.,Clinical Research Division Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Lynn E Onstad
- Clinical Research Division Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Jerald Radich
- Department of Medicine Division of Oncology, University of Washington, Seattle, WA, USA.,Clinical Research Division Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Celestia S Higano
- Department of Medicine Division of Oncology, University of Washington, Seattle, WA, USA.,Clinical Research Division Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Seattle Cancer Care Alliance, Seattle, WA, USA
| |
Collapse
|
103
|
Frazao A, Rethacker L, Messaoudene M, Avril MF, Toubert A, Dulphy N, Caignard A. NKG2D/NKG2-Ligand Pathway Offers New Opportunities in Cancer Treatment. Front Immunol 2019; 10:661. [PMID: 30984204 PMCID: PMC6449444 DOI: 10.3389/fimmu.2019.00661] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/11/2019] [Indexed: 12/18/2022] Open
Abstract
The antitumor functions of NK cells are regulated by the integration of positive and negative signals triggered by numerous membrane receptors present on the NK cells themselves. Among the main activating receptors, NKG2D binds several stress-induced molecules on tumor targets. Engagement of NKG2D by its ligands (NKG2D-Ls) induces NK cell activation leading to production of cytokines and target cell lysis. These effects have therapeutic potential as NKG2D-Ls are widely expressed by solid tumors, whereas their expression in healthy cells is limited. Here, we describe the genetic and environmental factors regulating the NKG2D/NKG2D-L pathway in tumors. NKG2D-L expression is linked to cellular stress and cell proliferation, and has been associated with oncogenic mutations. Tumors have been found to alter their to NKG2D-L expression as they progress, which interferes with the antitumor function of the pathway. Nevertheless, this pathway could be advantageously exploited for cancer therapy. Various cancer treatments, including chemotherapy and targeted therapies, indirectly interfere with the cellular and soluble forms of NKG2D-Ls. In addition, NKG2D introduced into chimeric antigen receptors in T- and NK cells is a promising tumor immunotherapy approach.
Collapse
Affiliation(s)
- Alexandra Frazao
- INSERMU1160, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, Paris, France
| | - Louise Rethacker
- INSERMU1160, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, Paris, France
| | - Meriem Messaoudene
- INSERMU1160, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, Paris, France.,U1015 INSERM-CIC, Institut Gustave Roussy, Villejuif, France
| | - Marie-Françoise Avril
- Assistance Publique-Hôpitaux de Paris, Department of Dermatology, Hospital Cochin, University Paris Descartes, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Paris, France
| | - Antoine Toubert
- INSERMU1160, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Department of Immunology and Histocompatibility, Paris, France
| | - Nicolas Dulphy
- INSERMU1160, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, Paris, France.,Univ Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Department of Immunology and Histocompatibility, Paris, France
| | - Anne Caignard
- INSERMU1160, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, Paris, France
| |
Collapse
|
104
|
Predicting hepatic complications of allogeneic hematopoietic stem cell transplantation using liver stiffness measurement. Bone Marrow Transplant 2019; 54:1738-1746. [DOI: 10.1038/s41409-019-0464-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 02/07/2023]
|
105
|
Early and late hematologic toxicity following CD19 CAR-T cells. Bone Marrow Transplant 2019; 54:1643-1650. [PMID: 30809033 DOI: 10.1038/s41409-019-0487-3] [Citation(s) in RCA: 244] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/11/2019] [Accepted: 02/13/2019] [Indexed: 12/12/2022]
Abstract
Autologous T cells transduced with CD19-directed chimeric antigen receptors have recently been approved by several regulatory agencies for the treatment of relapsed and refractory leukemia and lymphoma, after demonstrating remarkable remission rate in advanced patients. The most common adverse events reported are cytokine-release syndrome (CRS), neurotoxicity, and hematologic toxicity. Here, we focus on early and late cytopenia occurring after CD19 CAR-T cells in 38 patients treated with CD19 CAR-T cells. Neutropenia, thrombocytopenia, and anemia occur frequently (94, 80, and 51%, respectively) after CAR-T cell infusion, and are associated with a biphasic nature, as in 93% of patients hematologic toxicity occurs after 21 days from cell infusion. Late hematologic toxicity was more common in patients with high grade CRS and in patients treated after a recent stem cell transplantation. Interestingly, since these events occur late after the lymphodepleting chemotherapy and after resolution of CRS, we found perturbations in SDF-1 levels to correlate with events of late neutropenia, likely associated with B-cell recovery.
Collapse
|
106
|
Sauer T, Rooney CM. Current challenges for CAR T-cell therapy of acute myeloid leukemia. Transfusion 2019; 59:1171-1173. [PMID: 30762880 DOI: 10.1111/trf.15199] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 01/28/2019] [Indexed: 12/20/2022]
Abstract
KEY IDEAS Chimeric antigen receptor (CAR) T-cell therapy has the potential to improve the dismal outcome of patients diagnosed with acute myeloid leukemia (AML). A major challenge for CAR T-cell therapy of AML patients is identifying leukemia-specific target antigens. Immune escape through down-regulation of target antigens and/or a suppressive tumor microenvironment jeopardizes the success of CAR T-cell therapy.
Collapse
Affiliation(s)
- Tim Sauer
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas
| | - Cliona M Rooney
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas.,Department of Molecular Virology and Immunology, Baylor College of Medicine, Houston, Texas
| |
Collapse
|
107
|
Mchayleh W, Bedi P, Sehgal R, Solh M. Chimeric Antigen Receptor T-Cells: The Future is Now. J Clin Med 2019; 8:jcm8020207. [PMID: 30736426 PMCID: PMC6406995 DOI: 10.3390/jcm8020207] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 12/27/2022] Open
Abstract
The immune system acting via cancer immune-surveillance is considered a potential target for improving outcomes among some malignancies. The ability to harness immune cells, engineer them and educate them to target cancer cells has changed the paradigm for treating non-Hodgkin’s lymphomas (NHL) and acute lymphoblastic leukemia (ALL). Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable anti-tumor activity against refractory B cell malignancies. Ongoing research aims to expand the scope of this adoptive cell therapy, understanding mechanisms of resistance and reducing toxicity. In this review, we will discuss the current scope of CAR T-cell therapy and ongoing future applications.
Collapse
Affiliation(s)
- Wassim Mchayleh
- Department of Medicine, Northside Hospital Cancer Institute, Atlanta, GA 30342, USA.
| | - Prabhjot Bedi
- Department of Medicine, University of Pittsburgh Center East, Monroeville, PA 15146, USA.
| | - Rajesh Sehgal
- Department of Medicine, University of Pittsburgh Center East, Monroeville, PA 15146, USA.
| | - Melhem Solh
- Department of Medicine, Northside Hospital Cancer Institute, Atlanta, GA 30342, USA.
- Blood and Marrow Transplant, Acute Leukemia and Immunotherapy Program, Northside Hospital, Atlanta, GA 30342, USA.
| |
Collapse
|
108
|
Metzger ML, Mauz-Körholz C. Epidemiology, outcome, targeted agents and immunotherapy in adolescent and young adult non-Hodgkin and Hodgkin lymphoma. Br J Haematol 2019; 185:1142-1157. [PMID: 30729493 DOI: 10.1111/bjh.15789] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The epidemiology, outcome and targeted immunotherapy in adolescent and young adult non-Hodgkin and Hodgkin lymphoma were discussed during the 6th International Symposium on Childhood, Adolescent and Young Adult Non-Hodgkin Lymphoma September 26th-29th 2018 in Rotterdam, the Netherlands. This review summarizes some of those presentations, as well as other current and novel antibody therapy, immune check-point inhibitors, chimeric antigen receptor T cells, cancer vaccines and cytotoxic T lymphocyte therapy.
Collapse
Affiliation(s)
- Monika L Metzger
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Christine Mauz-Körholz
- Pädiatrische Hämatologie und Onkologie, Justus-Liebig-Universität Gießen and Medical Faculty of the Martin-Luther University of Halle, Germany
| |
Collapse
|
109
|
Cell-based immunotherapy approaches for multiple myeloma. Br J Cancer 2018; 120:38-44. [PMID: 30518815 PMCID: PMC6325139 DOI: 10.1038/s41416-018-0346-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 12/31/2022] Open
Abstract
Despite the arrival of novel therapies, multiple myeloma (MM) remains incurable and new treatment options are needed. Chimeric antigen receptor (CAR) T cells are genetically modified T cells that express a CAR directed against specific tumour antigens. CAR T cells are able to kill target tumour cells and may result in long-lasting immune responses in vivo. The rapid development of CAR technologies has led to clinical trials in haematological cancers including MM, and CAR T cells might evolve into a standard treatment in the next few years. Only small patient cohorts with relapsed or refractory disease have so far been investigated, but promising preliminary results with high response rates have been obtained in phase I clinical trials with B cell maturation antigen (BCMA), CD19, CD38 and κ-light-chain CAR T cells. Additional preclinical studies on CD38 and SLAMF7-CAR T cells in MM treatment yielded preclinical results that merit further investigation. Beyond the T cell approach, recent studies have focussed on CAR natural killer (NK) cells in order to increase the reactivity of these effector cells. Finally, to investigate the targeting of intracellular antigens, cellular therapies based on engineered T cell receptors (TCRs) are in development. In this review, we discuss results from preclinical and early-phase clinical trials testing the feasibility and safety of CAR T cell administration in MM, as well as early studies into approaches that utilise CAR NK cell and genetically modified TCRs.
Collapse
|
110
|
Park J, Inwood S, Kruthiventi S, Jenkins J, Shiloach J, Betenbaugh M. Progressing from transient to stable packaging cell lines for continuous production of lentiviral and gammaretroviral vectors. Curr Opin Chem Eng 2018. [DOI: 10.1016/j.coche.2018.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
111
|
Algeri M, Del Bufalo F, Galaverna F, Locatelli F. Current and future role of bispecific T-cell engagers in pediatric acute lymphoblastic leukemia. Expert Rev Hematol 2018; 11:945-956. [PMID: 30358451 DOI: 10.1080/17474086.2018.1540928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The clinical application of immunotherapy has resulted into a significant improvement in the outcome of children with relapsed/refractory B-cell precursor acute lymphoblastic leukemia (r/r BCP-ALL). In this setting, the use of bispecific T-cell-engager antibodies (BiTEs), such as blinatumomab, which harness the cytotoxic activity of T cells against CD19-positive lymphoblasts, has emerged as a most promising and impactful strategy. Areas covered: This review discusses the main structural and functional features of BiTEs, as well as the current status of their clinical application in childhood ALL. Moreover, future prospects to increase the efficacy of BiTEs are addressed. Expert commentary: The promising results obtained in patients with advanced BCP-ALL pave the way for further improvement in the context of less resistant/advanced disease. Future research is rapidly progressing on several aspects, including the use of blinatumomab in first-line protocols, identification of factors predicting response, use of combinatorial approaches and bioengineering of new molecules with dual specificity or increased potency, stability and half-life. The results of these studies, expected to be available in the next future, will provide further advancement in the development of effective, impactful, targeted immunotherapy for treatment of childhood BCP-ALL, with the concrete potential to revolutionize the clinical practice.
Collapse
Affiliation(s)
- Mattia Algeri
- a Department of Pediatric Hematology and Oncology , IRCCS, Ospedale Pediatrico Bambino Gesù , Rome , Italy
| | - Francesca Del Bufalo
- a Department of Pediatric Hematology and Oncology , IRCCS, Ospedale Pediatrico Bambino Gesù , Rome , Italy
| | - Federica Galaverna
- a Department of Pediatric Hematology and Oncology , IRCCS, Ospedale Pediatrico Bambino Gesù , Rome , Italy
| | - Franco Locatelli
- a Department of Pediatric Hematology and Oncology , IRCCS, Ospedale Pediatrico Bambino Gesù , Rome , Italy.,b Department of Pediatrics , University of Pavia , Pavia , Italy
| |
Collapse
|
112
|
Alcantara M, Tesio M, June CH, Houot R. CAR T-cells for T-cell malignancies: challenges in distinguishing between therapeutic, normal, and neoplastic T-cells. Leukemia 2018; 32. [PMID: 30315238 PMCID: PMC7433349 DOI: 10.1038/s41375-018-0285-8 10.1038/s41375-018-0285-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chimeric antigen receptor (CAR) T-cells targeting CD19 demonstrated remarkable efficacy for the treatment of B-cell malignancies. The development of CAR T-cells against T-cell malignancies appears more challenging due to the similarities between the therapeutic, normal and malignant T-cells. The obstacles include CAR T-cell fratricide, T-cell aplasia, and contamination of CAR T-cell products with malignant T-cells. Here, we review these challenges and propose solutions to overcome these limitations.
Collapse
Affiliation(s)
- Marion Alcantara
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants Malades, Paris, France,Institut Necker Enfants Malades (INEM), Institut National de Recherche Médicale (INSERM) U1151, Paris, France
| | - Melania Tesio
- Institut Necker Enfants Malades (INEM), Institut National de Recherche Médicale (INSERM) U1151, Paris, France
| | - Carl H. June
- Center for Cellular Immunotherapies, Perlman School of Medicine, Philadelphia, PA, USA,Parker Institute for Cancer Immunotherapy, University of Pennsylvania, Philadelphia, PA, USA,Department of Pathology and Laboratory Medicine, Perlman School of Medicine, Philadelphia, PA, USA
| | - Roch Houot
- CHU Rennes, Service Hématologie Clinique, 35033 Rennes, France,INSERM, U1236, 35043 Rennes, France,INSERM 0203, Unité d’Investigation Clinique, 35033 Rennes, France
| |
Collapse
|
113
|
Hale M, Rawlings DJ, Jackson SW. The long and the short of it: insights into the cellular source of autoantibodies as revealed by B cell depletion therapy. Curr Opin Immunol 2018; 55:81-88. [PMID: 30390507 DOI: 10.1016/j.coi.2018.10.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/17/2018] [Indexed: 10/28/2022]
Abstract
High titers of pathogenic autoantibodies are a hallmark of many autoimmune diseases. However, much remains unknown about the self-reactive plasma cells that are key mediators of disease. We propose a model in which the varying efficacy of precursor B cell depletion for the treatment of humoral autoimmunity can be explained by differences in the relative contributions of pathogenic antibodies by short-lived versus long-lived plasma cells. Beyond therapeutic considerations, this model suggests that we can infer the cellular source of disease-associated autoantibodies by the durability of serum titers following B cell depletion. Data from clinical trials and animal models across different autoimmune diseases may provide useful insights into the lifespan, lifestyle and fate of autoreactive plasma cells.
Collapse
Affiliation(s)
- Malika Hale
- Seattle Children's Research Institute, Seattle, WA, United States
| | - David J Rawlings
- Seattle Children's Research Institute, Seattle, WA, United States; Department of Immunology, University of Washington, School of Medicine, United States; Department of Pediatrics, University of Washington, School of Medicine, United States
| | - Shaun W Jackson
- Seattle Children's Research Institute, Seattle, WA, United States; Department of Pediatrics, University of Washington, School of Medicine, United States.
| |
Collapse
|
114
|
Morsink LM, Walter RB, Ossenkoppele GJ. Prognostic and therapeutic role of CLEC12A in acute myeloid leukemia. Blood Rev 2018; 34:26-33. [PMID: 30401586 DOI: 10.1016/j.blre.2018.10.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/17/2018] [Accepted: 10/30/2018] [Indexed: 02/07/2023]
Abstract
CLEC12A has recently been identified as an antigen, expressed on leukemic stem cells and leukemic blasts. Given the fact that this expression profile seems stable throughout diagnosis, treatment and relapse on leukemic blasts and leukemic stem cells, CLEC12A can be considered a highly potent and reliable marker for the detection of measurable residual disease and therefore applicable for risk stratification and prognostication in AML. Low CLEC12A expression on leukemic blasts seems to be independently associated with lower likelihood of achieving complete remission after 1 cycle of induction chemotherapy, shorter event free survival, as well as overall survival, indicating potential prognostic properties of CLEC12A expression itself. Lack of expression on the normal hematopoietic stem and progenitor cells, in contrast to CD123 and CD33, might result in less toxicity regarding cytopenias, making CLEC12A an interesting target for innovating immunotherapies, including monoclonal and bispecific antibodies, antibody-drug conjugates and CAR-T cells therapy.
Collapse
Affiliation(s)
- Linde M Morsink
- Department of Hematology, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands.
| | - Roland B Walter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Medicine, Division of Hematology, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Gert J Ossenkoppele
- Department of Hematology, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| |
Collapse
|
115
|
CAR T-cells for T-cell malignancies: challenges in distinguishing between therapeutic, normal, and neoplastic T-cells. Leukemia 2018; 32:2307-2315. [PMID: 30315238 DOI: 10.1038/s41375-018-0285-8] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/24/2018] [Accepted: 09/12/2018] [Indexed: 12/20/2022]
Abstract
Chimeric antigen receptor (CAR) T-cells targeting CD19 demonstrated remarkable efficacy for the treatment of B-cell malignancies. The development of CAR T-cells against T-cell malignancies appears more challenging due to the similarities between the therapeutic, normal and malignant T-cells. The obstacles include CAR T-cell fratricide, T-cell aplasia, and contamination of CAR T-cell products with malignant T-cells. Here, we review these challenges and propose solutions to overcome these limitations.
Collapse
|
116
|
Consonni M, Dellabona P, Casorati G. Potential advantages of CD1-restricted T cell immunotherapy in cancer. Mol Immunol 2018; 103:200-208. [PMID: 30308433 DOI: 10.1016/j.molimm.2018.09.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/01/2018] [Accepted: 09/29/2018] [Indexed: 12/11/2022]
Abstract
Adoptive cell therapy (ACT) using tumor-specific "conventional" MHC-restricted T cells obtained from tumor-infiltrating lymphocytes, or derived ex vivo by either antigen-specific expansion or genetic engineering of polyclonal T cell populations, shows great promise for cancer treatment. However, the wide applicability of this therapy finds limits in the high polymorphism of MHC molecules that restricts the use in the autologous context. CD1 antigen presenting molecules are nonpolymorphic and specialized for lipid antigen presentation to T cells. They are often expressed on malignant cells and, therefore, may represent an attractive target for ACT. We provide a brief overview of the CD1-resticted T cell response in tumor immunity and we discuss the pros and cons of ACT approaches based on unconventional CD1-restricted T cells.
Collapse
Affiliation(s)
- Michela Consonni
- Experimental Immunology Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
| | - Paolo Dellabona
- Experimental Immunology Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy
| | - Giulia Casorati
- Experimental Immunology Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy
| |
Collapse
|