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Cabrera-Maqueda JM, Sepulveda M, García RR, Muñoz-Sánchez G, Martínez-Cibrian N, Ortíz-Maldonado V, Lorca-Arce D, Guasp M, Llufriu S, Martinez-Hernandez E, Armangue T, Fonseca EG, Alba-Isasi MT, Delgado J, Dalmau J, Juan M, Saiz A, Blanco Y. CD19-Directed CAR T-Cells in a Patient With Refractory MOGAD: Clinical and Immunologic Follow-Up for 1 Year. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200292. [PMID: 39106426 PMCID: PMC11309560 DOI: 10.1212/nxi.0000000000200292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/10/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVES In MOG antibody-associated disease (MOGAD), relapse prevention and the treatment approach to refractory symptoms are unknown. We report a patient with refractory MOGAD treated with CD19-directed CAR T-cells. METHODS CD19-directed CAR T-cells (ARI-0001) were produced in-house by lentiviral transduction of autologous fresh leukapheresis and infused after a conventional lymphodepleting regimen. RESULTS A 18-year-old man developed 2 episodes of myelitis associated with serum MOG-IgG, which were followed by 6 episodes of left optic neuritis (ON) and sustained the presence of MOG-IgG over 6 years despite multiple immunotherapies. After the sixth episode of ON, accompanied by severe residual visual deficits, CAR T-cell treatment was provided without complications. Follow-up of cell counts showed complete depletion of CD19+ B cells at day +7; reconstituted B cells at day +141 showing a naïve B-cell phenotype, and low or absent memory B cells and plasmablasts for 1 year. MOG-IgG titers have remained undetectable since CAR T-cell infusion. The patient had an early episode of left ON at day +29, when MOG-IgG was already negative, and since then he has remained free of relapses without immunotherapy for 1 year. DISCUSSION This clinical case shows that CD19-directed CAR T-cell therapy is well-tolerated and is a potential treatment for patients with refractory MOGAD. CLASSIFICATION OF EVIDENCE This provides Class IV evidence. It is a single observational study without controls.
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Affiliation(s)
- Jose Maria Cabrera-Maqueda
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Maria Sepulveda
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Raquel Ruiz García
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Guillermo Muñoz-Sánchez
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Nuria Martínez-Cibrian
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Valentín Ortíz-Maldonado
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Daniel Lorca-Arce
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Mar Guasp
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Sara Llufriu
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Eugenia Martinez-Hernandez
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Thais Armangue
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Elianet G Fonseca
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - María Teresa Alba-Isasi
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Julio Delgado
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Josep Dalmau
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Manel Juan
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Albert Saiz
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Yolanda Blanco
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
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Russell GC, Hamzaoui Y, Rho D, Sutrave G, Choi JS, Missan DS, Reckard GA, Gustafson MP, Kim GB. Synthetic biology approaches for enhancing safety and specificity of CAR-T cell therapies for solid cancers. Cytotherapy 2024; 26:842-857. [PMID: 38639669 DOI: 10.1016/j.jcyt.2024.03.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024]
Abstract
CAR-T cell therapies have been successful in treating numerous hematologic malignancies as the T cell can be engineered to target a specific antigen associated with the disease. However, translating CAR-T cell therapies for solid cancers is proving more challenging due to the lack of truly tumor-associated antigens and the high risk of off-target toxicities. To combat this, numerous synthetic biology mechanisms are being incorporated to create safer and more specific CAR-T cells that can be spatiotemporally controlled with increased precision. Here, we seek to summarize and analyze the advancements for CAR-T cell therapies with respect to clinical implementation, from the perspective of synthetic biology and immunology. This review should serve as a resource for further investigation and growth within the field of personalized cellular therapies.
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Affiliation(s)
- Grace C Russell
- Department of Physiology and Biomedical Engineering, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Yassin Hamzaoui
- Department of Physiology and Biomedical Engineering, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Daniel Rho
- Department of Physiology and Biomedical Engineering, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Gaurav Sutrave
- The University of Sydney, Sydney, Australia; Department of Haematology, Westmead Hospital, Sydney, Australia; Immuno & Gene Therapy Committee, International Society for Cell and Gene Therapy, Vancouver, Canada
| | - Joseph S Choi
- Department of Physiology and Biomedical Engineering, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Dara S Missan
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Gabrielle A Reckard
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Michael P Gustafson
- Immuno & Gene Therapy Committee, International Society for Cell and Gene Therapy, Vancouver, Canada; Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, Arizona, USA; Department of Immunology, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | - Gloria B Kim
- Department of Physiology and Biomedical Engineering, Mayo Clinic Arizona, Scottsdale, Arizona, USA; Department of Immunology, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
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3
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Bexte T, Botezatu L, Miskey C, Gierschek F, Moter A, Wendel P, Reindl LM, Campe J, Villena-Ossa JF, Gebel V, Stein K, Cathomen T, Cremer A, Wels WS, Hudecek M, Ivics Z, Ullrich E. Engineering of potent CAR NK cells using non-viral Sleeping Beauty transposition from minimalistic DNA vectors. Mol Ther 2024; 32:2357-2372. [PMID: 38751112 PMCID: PMC11287004 DOI: 10.1016/j.ymthe.2024.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/25/2024] [Accepted: 05/09/2024] [Indexed: 06/06/2024] Open
Abstract
Natural killer (NK) cells have high intrinsic cytotoxic capacity, and clinical trials have demonstrated their safety and efficacy for adoptive cancer therapy. Expression of chimeric antigen receptors (CARs) enhances NK cell target specificity, with these cells applicable as off-the-shelf products generated from allogeneic donors. Here, we present for the first time an innovative approach for CAR NK cell engineering employing a non-viral Sleeping Beauty (SB) transposon/transposase-based system and minimized DNA vectors termed minicircles. SB-modified peripheral blood-derived primary NK cells displayed high and stable CAR expression and more frequent vector integration into genomic safe harbors than lentiviral vectors. Importantly, SB-generated CAR NK cells demonstrated enhanced cytotoxicity compared with non-transfected NK cells. A strong antileukemic potential was confirmed using established acute lymphocytic leukemia cells and patient-derived primary acute B cell leukemia and lymphoma samples as targets in vitro and in vivo in a xenograft leukemia mouse model. Our data suggest that the SB-transposon system is an efficient, safe, and cost-effective approach to non-viral engineering of highly functional CAR NK cells, which may be suitable for cancer immunotherapy of leukemia as well as many other malignancies.
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Affiliation(s)
- Tobias Bexte
- Goethe University, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany; University Cancer Center (UCT) Frankfurt, Frankfurt, Germany; Mildred Scheel Career Center (MSNZ), Hospital of the Goethe University Frankfurt, Frankfurt, Germany; Institute for Transfusion Medicine and Immunohematology, German Red Cross Blood Service Baden-Württemberg - Hesse, Frankfurt, Germany
| | - Lacramioara Botezatu
- Research Centre, Division of Hematology, Gene and Cell Therapy, Paul-Ehrlich-Institut, Langen, Germany; German Cancer Consortium (DKTK), partner site Heidelberg, Heidelberg, Germany
| | - Csaba Miskey
- Research Centre, Division of Hematology, Gene and Cell Therapy, Paul-Ehrlich-Institut, Langen, Germany
| | - Fenja Gierschek
- Goethe University, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
| | - Alina Moter
- Goethe University, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
| | - Philipp Wendel
- Goethe University, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany; German Cancer Consortium (DKTK), partner site Frankfurt/Mainz and German Cancer Research Center (DKFZ), Heidelberg, Germany; Institute for Organic Chemistry and Biochemistry, Technical University of Darmstadt, Darmstadt, Germany
| | - Lisa Marie Reindl
- Goethe University, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
| | - Julia Campe
- Goethe University, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany
| | - Jose Francisco Villena-Ossa
- Institute for Transfusion Medicine and Gene Therapy, Medical Center - University of Freiburg, Freiburg, Germany; Center for Chronic Immunodeficiency, Medical Center - University of Freiburg, Freiburg, Germany
| | - Veronika Gebel
- Goethe University, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany; University Cancer Center (UCT) Frankfurt, Frankfurt, Germany; Mildred Scheel Career Center (MSNZ), Hospital of the Goethe University Frankfurt, Frankfurt, Germany
| | - Katja Stein
- Goethe University, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany; University Cancer Center (UCT) Frankfurt, Frankfurt, Germany
| | - Toni Cathomen
- Institute for Transfusion Medicine and Gene Therapy, Medical Center - University of Freiburg, Freiburg, Germany; Center for Chronic Immunodeficiency, Medical Center - University of Freiburg, Freiburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany; German Cancer Consortium (DKTK), partner site Freiburg, Freiburg, Germany
| | - Anjali Cremer
- Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany; University Cancer Center (UCT) Frankfurt, Frankfurt, Germany; Mildred Scheel Career Center (MSNZ), Hospital of the Goethe University Frankfurt, Frankfurt, Germany; German Cancer Consortium (DKTK), partner site Frankfurt/Mainz and German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Hematology/Oncology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Winfried S Wels
- Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany; German Cancer Consortium (DKTK), partner site Frankfurt/Mainz and German Cancer Research Center (DKFZ), Heidelberg, Germany; Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Michael Hudecek
- Department of Medicine II, Chaire in Cellular Immunotherapy, University Hospital Würzburg, Würzburg, Germany; Fraunhofer Institute for Cell Therapy and Immunology, Cellular Immunotherapy Branch Site Würzburg, Würzburg, Germany
| | - Zoltán Ivics
- Research Centre, Division of Hematology, Gene and Cell Therapy, Paul-Ehrlich-Institut, Langen, Germany; German Cancer Consortium (DKTK), partner site Heidelberg, Heidelberg, Germany
| | - Evelyn Ullrich
- Goethe University, Department of Pediatrics, Experimental Immunology and Cell Therapy, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany; University Cancer Center (UCT) Frankfurt, Frankfurt, Germany; Mildred Scheel Career Center (MSNZ), Hospital of the Goethe University Frankfurt, Frankfurt, Germany; German Cancer Consortium (DKTK), partner site Frankfurt/Mainz and German Cancer Research Center (DKFZ), Heidelberg, Germany.
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4
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Peyrony O, Garcia-Pouton N, Chumbita M, Teijon-Lumbreras C, Aiello TF, Monzó-Gallo P, Gallardo-Pizarro A, Ortiz-Maldonado V, Martinez-Cibrian N, Delgado J, Fernandez de Larrea C, Mensa J, Puerta-Alcalde P, Soriano A, Garcia-Vidal C. Chimeric Antigen Receptor T-Cell Postinfusion Fever: Infection Profile, Clinical Parameters, and Biomarkers Trends to Assist Antibiotic Stewardship. Open Forum Infect Dis 2024; 11:ofae398. [PMID: 39070045 PMCID: PMC11273324 DOI: 10.1093/ofid/ofae398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/09/2024] [Indexed: 07/30/2024] Open
Abstract
Background This study aimed to describe documented infections associated with postinfusion fever after CAR T-cell therapy and to evaluate daily changes in vital signs, laboratory results, and the National Early Warning Score (NEWS) in patients with and without confirmed bacterial infections following fever onset, with the objective of assisting in antibiotic stewardship. Methods This was a retrospective, observational study including all consecutive adult patients who received CAR T-cell therapy. Documented infection in the first fever episode after infusion, and clinical and analytic trend comparison of patients with bacterial documented infections and those without documented infections, are described. Results Among 152 patients treated with CAR T-cell therapy, 87 (57.2%) had fever within 30 days of infusion, with a median time from infusion to fever of 3 (interquartile range, 2-5) days. Of these 87 patients, 82 (94.3%) received broad-spectrum antibiotics. Infection was documented in 9 (10.3%) patients and only 4 (4.6%) had bacterial infections. Clinical signs and biomarkers were similar in patients with bacterial documented infection and in those without documented infection at fever onset. Fever, tachycardia, and high C-reactive protein levels remained high during the first 3 days after CAR T-cell infusion, even when no infection was documented. Conclusions Fever is a common symptom following CAR T-cell infusion and is largely treated with broad-spectrum antibiotics. However, confirmed bacterial documented infections after the first fever post-CAR T-cell infusion are very unusual. Because clinical parameters and biomarkers are not useful for identifying infectious fever, other methods should be assessed to ensure the proper use of antibiotics.
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Affiliation(s)
- Olivier Peyrony
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain
- Emergency Department, Hôpital Saint-Louis, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Nicole Garcia-Pouton
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Mariana Chumbita
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Christian Teijon-Lumbreras
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Tommaso Francesco Aiello
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Patricia Monzó-Gallo
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Antonio Gallardo-Pizarro
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Valentín Ortiz-Maldonado
- Department of Hematology, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Núria Martinez-Cibrian
- Department of Hematology, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Carlos Fernandez de Larrea
- Department of Hematology, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Josep Mensa
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Pedro Puerta-Alcalde
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Alex Soriano
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
- CIBERINFECT, Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Madrid, Spain
| | - Carolina Garcia-Vidal
- Department of Infectious Diseases, Hospital Clinic of Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer, University of Barcelona, Barcelona, Spain
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5
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Malakhova E, Pershin D, Kulakovskaya E, Vedmedskaia V, Fadeeva M, Lodoeva O, Sozonova T, Muzalevskii Y, Kazachenok A, Belchikov V, Shelikhova L, Molostova O, Volkov D, Maschan M. Extended characterization of anti-CD19 CAR T cell products manufactured at the point of care using the CliniMACS Prodigy system: comparison of donor sources and process duration. Cytotherapy 2024; 26:567-578. [PMID: 38493403 DOI: 10.1016/j.jcyt.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND AIMS The CliniMACS Prodigy closed system is widely used for the manufacturing of chimeric antigen receptor T cells (CAR-T cells). Our study presents an extensive immunophenotypic and functional characterization and comparison of the properties of anti-CD19 CAR-T cell products obtained during long (11 days) and short (7 days) manufacturing cycles using the CliniMACS Prodigy system, as well as cell products manufactured from different donor sources of T lymphocytes: from patients, from patients who underwent HSCT, and from haploidentical donors. We also present the possibility of assessing the efficiency of transduction by an indirect method. METHODS Seventy-six CD19 CAR-T cell products were manufactured using the CliniMACS Prodigy automated system. Immunophenotypic properties, markers of cell activation and exhaustion, antitumor, anti-CD19 specific activity in vitro of the manufactured cell products were evaluated. As an indirect method for assessing the efficiency of transduction, we used the method of functional assessment of cytokine secretion and expression of the CD107a marker after incubation of CAR-T cells with tumor targets. RESULTS The CliniMACS Prodigy platform can produce a product of CD19 CAR-T cells with sufficient cell expansion (4.6 × 109 cells-median for long process [LP] and 1.6 × 109-for short process [SP]), transduction efficiency (43.5%-median for LP and 41.0%-for SP), represented mainly by T central memory cell population, with low expression of exhaustion markers, and with high specific antitumor activity in vitro. We did not find significant differences in the properties of the products obtained during the 7- and 11-day manufacturing cycles, which is in favor of reducing the duration of production to 7 days, which may accelerate CAR-T therapy. We have shown that donor sources for CAR-T manufacturing do not significantly affect the composition and functional properties of the cell product. CONCLUSIONS This study demonstrates the possibility of using the CliniMACS Prodigy system with a shortened 7-day production cycle to produce sufficient amount of functional CAR-T cells. CAR transduction efficiency can be measured indirectly via functional assays.
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Affiliation(s)
- Ekaterina Malakhova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia.
| | - Dmitriy Pershin
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Elena Kulakovskaya
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Viktoria Vedmedskaia
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Mariia Fadeeva
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Oyuna Lodoeva
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Tatiana Sozonova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Yakov Muzalevskii
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Alexei Kazachenok
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Vladislav Belchikov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Larisa Shelikhova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Olga Molostova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - Dmitry Volkov
- M.M. Shemyakin and Yu.A. Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences, Moscow, Russia
| | - Michael Maschan
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
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6
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Metzloff AE, Padilla MS, Gong N, Billingsley MM, Han X, Merolle M, Mai D, Figueroa-Espada CG, Thatte AS, Haley RM, Mukalel AJ, Hamilton AG, Alameh MG, Weissman D, Sheppard NC, June CH, Mitchell MJ. Antigen Presenting Cell Mimetic Lipid Nanoparticles for Rapid mRNA CAR T Cell Cancer Immunotherapy. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2313226. [PMID: 38419362 PMCID: PMC11209815 DOI: 10.1002/adma.202313226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/05/2024] [Indexed: 03/02/2024]
Abstract
Chimeric antigen receptor (CAR) T cell therapy has achieved remarkable clinical success in the treatment of hematological malignancies. However, producing these bespoke cancer-killing cells is a complicated ex vivo process involving leukapheresis, artificial T cell activation, and CAR construct introduction. The activation step requires the engagement of CD3/TCR and CD28 and is vital for T cell transfection and differentiation. Though antigen-presenting cells (APCs) facilitate activation in vivo, ex vivo activation relies on antibodies against CD3 and CD28 conjugated to magnetic beads. While effective, this artificial activation adds to the complexity of CAR T cell production as the beads must be removed prior to clinical implementation. To overcome this challenge, this work develops activating lipid nanoparticles (aLNPs) that mimic APCs to combine the activation of magnetic beads and the transfection capabilities of LNPs. It is shown that aLNPs enable one-step activation and transfection of primary human T cells with the resulting mRNA CAR T cells reducing tumor burden in a murine xenograft model, validating aLNPs as a promising platform for the rapid production of mRNA CAR T cells.
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Affiliation(s)
- Ann E Metzloff
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Marshall S Padilla
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ningqiang Gong
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Margaret M Billingsley
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Xuexiang Han
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Maria Merolle
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - David Mai
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Christian G Figueroa-Espada
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ajay S Thatte
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Rebecca M Haley
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Alvin J Mukalel
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Alex G Hamilton
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Mohamad-Gabriel Alameh
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Penn Institute for RNA Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Drew Weissman
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Penn Institute for RNA Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Neil C Sheppard
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Carl H June
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Michael J Mitchell
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Penn Institute for RNA Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Institute for Regenerative Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
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7
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Fox TA, Booth C. Improving access to gene therapy for rare diseases. Dis Model Mech 2024; 17:dmm050623. [PMID: 38639083 PMCID: PMC11051979 DOI: 10.1242/dmm.050623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024] Open
Abstract
Effective gene therapy approaches have been developed for many rare diseases, including inborn errors of immunity and metabolism, haemoglobinopathies and inherited blindness. Despite successful pre-clinical and clinical results, these gene therapies are not widely available, primarily for non-medical reasons. Lack of commercial interest in therapies for ultra-rare diseases, costs of development and complex manufacturing processes required for advanced therapy medicinal products (ATMPs) are some of the main problems that are restricting access. The complexities and costs of navigating the regulatory environments in different jurisdictions for treatments that affect small numbers of patients is a problem unique to ATMPS for rare and ultra-rare diseases. In this Perspective, we outline some of the challenges and potential solutions that, we hope, will improve access to gene therapy for rare diseases.
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Affiliation(s)
- Thomas A. Fox
- UCL Institute of Immunity and Transplantation, University College London, London, NW3 2PP, United Kingdom
| | - Claire Booth
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, UCL, London WC1N 1EH, UK
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8
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Andreu-Saumell I, Rodriguez-Garcia A, Mühlgrabner V, Gimenez-Alejandre M, Marzal B, Castellsagué J, Brasó-Maristany F, Calderon H, Angelats L, Colell S, Nuding M, Soria-Castellano M, Barbao P, Prat A, Urbano-Ispizua A, Huppa JB, Guedan S. CAR affinity modulates the sensitivity of CAR-T cells to PD-1/PD-L1-mediated inhibition. Nat Commun 2024; 15:3552. [PMID: 38670972 PMCID: PMC11053011 DOI: 10.1038/s41467-024-47799-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Chimeric antigen receptor (CAR)-T cell therapy for solid tumors faces significant hurdles, including T-cell inhibition mediated by the PD-1/PD-L1 axis. The effects of disrupting this pathway on T-cells are being actively explored and controversial outcomes have been reported. Here, we hypothesize that CAR-antigen affinity may be a key factor modulating T-cell susceptibility towards the PD-1/PD-L1 axis. We systematically interrogate CAR-T cells targeting HER2 with either low (LA) or high affinity (HA) in various preclinical models. Our results reveal an increased sensitivity of LA CAR-T cells to PD-L1-mediated inhibition when compared to their HA counterparts by using in vitro models of tumor cell lines and supported lipid bilayers modified to display varying PD-L1 densities. CRISPR/Cas9-mediated knockout (KO) of PD-1 enhances LA CAR-T cell cytokine secretion and polyfunctionality in vitro and antitumor effect in vivo and results in the downregulation of gene signatures related to T-cell exhaustion. By contrast, HA CAR-T cell features remain unaffected following PD-1 KO. This behavior holds true for CD28 and ICOS but not 4-1BB co-stimulated CAR-T cells, which are less sensitive to PD-L1 inhibition albeit targeting the antigen with LA. Our findings may inform CAR-T therapies involving disruption of PD-1/PD-L1 pathway tailored in particular for effective treatment of solid tumors.
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Affiliation(s)
- Irene Andreu-Saumell
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
| | - Alba Rodriguez-Garcia
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain.
| | - Vanessa Mühlgrabner
- Medical University of Vienna, Center for Pathophysiology, Infectiology and Immunology, Institute for Hygiene and Applied Immunology, Vienna, Austria
| | - Marta Gimenez-Alejandre
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
| | - Berta Marzal
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
| | - Joan Castellsagué
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
| | - Fara Brasó-Maristany
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
| | - Hugo Calderon
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
| | - Laura Angelats
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Salut Colell
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
| | - Mara Nuding
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
| | - Marta Soria-Castellano
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
| | - Paula Barbao
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
| | - Aleix Prat
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Alvaro Urbano-Ispizua
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Johannes B Huppa
- Medical University of Vienna, Center for Pathophysiology, Infectiology and Immunology, Institute for Hygiene and Applied Immunology, Vienna, Austria
| | - Sonia Guedan
- Oncology and Hematology Department, Fundació Clínic Recerca Biomédica- IDIBAPS, Barcelona, Spain.
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9
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Garcia-Pouton N, Ortiz-Maldonado V, Peyrony O, Chumbita M, Aiello TF, Monzo-Gallo P, Lopera C, Puerta-Alcalde P, Magnano L, Martinez-Cibrian N, Pitart C, Juan M, Delgado J, Fernandez De Larrea C, Soriano Á, Urbano-Ispizua Á, Garcia-Vidal C. Infection epidemiology in relation to different therapy phases in patients with haematological malignancies receiving CAR T-cell therapy. Eur J Haematol 2024; 112:371-378. [PMID: 37879842 DOI: 10.1111/ejh.14122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND We described the real-life epidemiology and causes of infections on the different therapy phases in patients undergoing chimeric antigen receptor (CAR) T-cells directed towards CD19+ or BCMA+ cells. METHODS All consecutive patients receiving CAR T-cell therapy at our institution were prospectively followed-up. We performed various comparative analyses of all patients and subgroups with and without infections. RESULTS Ninety-one adults mainly received CAR T-cell therapy for acute leukaemia (53%) and lymphoma (33%). We documented a total of 77 infections in 47 (52%) patients, 37 (48%) during the initial neutropenic phase and 40 (52%) during the non-neutropenic phase. Infections during the neutropenic phase were mainly due to bacterial (29, 78%): catheter infections (11 [38%] cases), endogenous source (5 [17%]), and Clostridioides difficile (5 [17%]). Patients receiving corticosteroids after CAR T-cell therapy had a higher risk of endogenous infection (100% vs. 16%; p = .006). During the non-neutropenic phase, bacterial infections remained very frequent (24, 60%), mainly with catheter source (8, 33%). Respiratory tract infections were common (17, 43%). CONCLUSIONS Infections after CAR T-cell therapy were frequent. During the neutropenic phase, it is essential to prevent nosocomial infections and balance the use of antibiotics to lower endogenous bacteraemia and Clostridial infection rates.
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Affiliation(s)
- Nicol Garcia-Pouton
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain
| | | | - Oliver Peyrony
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain
- Emergency Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mariana Chumbita
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Tommaso Francesco Aiello
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Patricia Monzo-Gallo
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Carlos Lopera
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Pedro Puerta-Alcalde
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Laura Magnano
- Haematology Department, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Nuria Martinez-Cibrian
- Haematology Department, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Cristina Pitart
- Microbiology Department, Hospital Clinic, University of Barcelona, ISGLOBAL, Barcelona, Spain
| | - Manel Juan
- Immunology Department, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Julio Delgado
- Haematology Department, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | | | - Álex Soriano
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBERINF, CIBER in Infectious Diseases, Barcelona, Spain
| | - Álvaro Urbano-Ispizua
- Haematology Department, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Carolina Garcia-Vidal
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBERINF, CIBER in Infectious Diseases, Barcelona, Spain
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10
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Martínez-Cibrián N, Ortiz-Maldonado V, Español-Rego M, Blázquez A, Cid J, Lozano M, Magnano L, Giné E, Correa JG, Mozas P, Rodríguez-Lobato LG, Rivero A, Montoro-Lorite M, Ayora P, Navarro S, Alserawan L, González-Navarro EA, Castellà M, Sánchez-Castañón M, Cabezón R, Benítez-Ribas D, Setoaín X, Rodríguez S, Brillembourg H, Varea S, Olesti E, Guillén E, Sáez-Peñataro J, de Larrea CF, López-Guillermo A, Pascal M, Urbano-Ispizua Á, Juan M, Delgado J. The academic point-of-care anti-CD19 chimeric antigen receptor T-cell product varnimcabtagene autoleucel (ARI-0001 cells) shows efficacy and safety in the treatment of relapsed/refractory B-cell non-Hodgkin lymphoma. Br J Haematol 2024; 204:525-533. [PMID: 37905734 DOI: 10.1111/bjh.19170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 11/02/2023]
Abstract
Varnimcabtagene autoleucel (var-cel) is an academic anti-CD19 chimeric antigen receptor (CAR) product used for the treatment of non-Hodgkin lymphoma (NHL) in the CART19-BE-01 trial. Here we report updated outcomes of patients with NHL treated with var-cel. B-cell recovery was compared with patients with acute lymphoblastic leukaemia (ALL). Forty-five patients with NHL were treated. Cytokine release syndrome (any grade) occurred in 84% of patients (4% grade ≥3) and neurotoxicity in 7% (2% grade ≥3). The objective response rate was 73% at Day +100, and the 3-year duration of response was 56%. The 3-year progression-free and overall survival were 40% and 52% respectively. High lactate dehydrogenase was the only covariate with an impact on progression-free survival. The 3-year incidence of B-cell recovery was lower in patients with NHL compared to ALL (25% vs. 60%). In conclusion, in patients with NHL, the toxicity of var-cel was manageable, while B-cell recovery was significantly prolonged compared to ALL. This trial was registered as NCT03144583.
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Affiliation(s)
| | - Valentín Ortiz-Maldonado
- Department of Hematology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marta Español-Rego
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Hospital Clínic, Barcelona, Spain
| | | | - Joan Cid
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Apheresis Unit, Hospital Clínic, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Miquel Lozano
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Apheresis Unit, Hospital Clínic, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Laura Magnano
- Department of Hematology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Eva Giné
- Department of Hematology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- CIBERONC, Madrid, Spain
| | - Juan G Correa
- Department of Hematology, Hospital Clínic, Barcelona, Spain
| | - Pablo Mozas
- Department of Hematology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Luis Gerardo Rodríguez-Lobato
- Department of Hematology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Andrea Rivero
- Department of Hematology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Pilar Ayora
- Department of Hematology, Hospital Clínic, Barcelona, Spain
| | - Sergio Navarro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Hospital Clínic, Barcelona, Spain
| | | | | | - Maria Castellà
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Hospital Clínic, Barcelona, Spain
| | | | - Raquel Cabezón
- Department of Immunology, Hospital Clínic, Barcelona, Spain
| | - Daniel Benítez-Ribas
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Hospital Clínic, Barcelona, Spain
| | - Xavier Setoaín
- University of Barcelona, Barcelona, Spain
- Department of Nuclear Medicine, Hospital Clínic, Barcelona, Spain
- CIBERBBN, Madrid, Spain
| | | | | | - Sara Varea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Clinical Pharmacology, Hospital Clínic, Barcelona, Spain
| | - Eulalia Olesti
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- Department of Clinical Pharmacology, Hospital Clínic, Barcelona, Spain
| | - Elena Guillén
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Clinical Pharmacology, Hospital Clínic, Barcelona, Spain
| | - Joaquín Sáez-Peñataro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Clinical Pharmacology, Hospital Clínic, Barcelona, Spain
| | - Carlos Fernández de Larrea
- Department of Hematology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- CIBERONC, Madrid, Spain
| | - Mariona Pascal
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Hospital Clínic, Barcelona, Spain
| | - Álvaro Urbano-Ispizua
- Department of Hematology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Manel Juan
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Hospital Clínic, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- CIBERONC, Madrid, Spain
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11
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Hoelzer D, Bassan R, Boissel N, Roddie C, Ribera JM, Jerkeman M. ESMO Clinical Practice Guideline interim update on the use of targeted therapy in acute lymphoblastic leukaemia. Ann Oncol 2024; 35:15-28. [PMID: 37832649 DOI: 10.1016/j.annonc.2023.09.3112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/14/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Affiliation(s)
- D Hoelzer
- ONKOLOGIKUM Frankfurt am Museumsufer, Frankfurt, Germany
| | - R Bassan
- Hematology Unit, Ospedale dell'Angelo e Ospedale SS, Giovanni e Paolo, Mestre-Venezia, Italy
| | - N Boissel
- Hematology Department, Saint-Louis Hospital, APHP, Institut de Recherche Saint-Louis, Université de Paris Cité, Paris, France
| | - C Roddie
- Research Department of Haematology, UCL Cancer Institute, London, UK
| | - J M Ribera
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - M Jerkeman
- Department of Oncology, Skåne University Hospital and Lund University, Lund, Sweden
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12
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Elsallab M, Maus MV. Expanding access to CAR T cell therapies through local manufacturing. Nat Biotechnol 2023; 41:1698-1708. [PMID: 37884746 DOI: 10.1038/s41587-023-01981-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 09/05/2023] [Indexed: 10/28/2023]
Abstract
Chimeric antigen receptor (CAR) T cells are changing the therapeutic landscape for hematological malignancies. To date, all six CAR T cell products approved by the US Food and Drug Administration (FDA) are autologous and centrally manufactured. As the numbers of approved products and indications continue to grow, new strategies to increase cell-manufacturing capacity are urgently needed to ensure patient access. Distributed manufacturing at the point of care or at other local manufacturing sites would go a long way toward meeting the rising demand. To ensure successful implementation, it is imperative to harness novel technologies to achieve uniform product quality across geographically dispersed facilities. This includes the use of automated cell-production systems, in-line sensors and process simulation for enhanced quality control and efficient supply chain management. A comprehensive effort to understand the critical quality attributes of CAR T cells would enable better definition of widely attainable release criteria. To supplement oversight by national regulatory agencies, we recommend expansion of the role of accreditation bodies. Moreover, regulatory standards may need to be amended to accommodate the unique characteristics of distributed manufacturing models.
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Affiliation(s)
- Magdi Elsallab
- Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, MA, USA
- Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Marcela V Maus
- Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Cancer Center, Massachusetts General Hospital, Boston, MA, USA.
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13
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Pérez-Amill L, Bataller À, Delgado J, Esteve J, Juan M, Klein-González N. Advancing CART therapy for acute myeloid leukemia: recent breakthroughs and strategies for future development. Front Immunol 2023; 14:1260470. [PMID: 38098489 PMCID: PMC10720337 DOI: 10.3389/fimmu.2023.1260470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/30/2023] [Indexed: 12/17/2023] Open
Abstract
Chimeric antigen receptor (CAR) T therapies are being developed for acute myeloid leukemia (AML) on the basis of the results obtained for other haematological malignancies and the need of new treatments for relapsed and refractory AML. The biggest challenge of CART therapy for AML is to identify a specific target antigen, since antigens expressed in AML cells are usually shared with healthy haematopoietic stem cells (HSC). The concomitant expression of the target antigen on both tumour and HSC may lead to on-target/off-tumour toxicity. In this review, we guide researchers to design, develop, and translate to the clinic CART therapies for the treatment of AML. Specifically, we describe what issues have to be considered to design these therapies; what in vitro and in vivo assays can be used to prove their efficacy and safety; and what expertise and facilities are needed to treat and manage patients at the hospital.
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Affiliation(s)
- Lorena Pérez-Amill
- Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Gyala Therapeutics S.L, Barcelona, Spain
- Department of Immunology, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Àlex Bataller
- Department of Haematology, Institut Clínic de Malalties Hematològiques i Oncològiques (ICHMO), Hospital Clínic de Barcelona, Barcelona, Spain
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Julio Delgado
- Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Department of Haematology, Institut Clínic de Malalties Hematològiques i Oncològiques (ICHMO), Hospital Clínic de Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Jordi Esteve
- Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Department of Haematology, Institut Clínic de Malalties Hematològiques i Oncològiques (ICHMO), Hospital Clínic de Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Manel Juan
- Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Department of Immunology, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain
| | - Nela Klein-González
- Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Gyala Therapeutics S.L, Barcelona, Spain
- Department of Immunology, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
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14
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Palomo M, Moreno-Castaño AB, Salas MQ, Escribano-Serrat S, Rovira M, Guillen-Olmos E, Fernandez S, Ventosa-Capell H, Youssef L, Crispi F, Nomdedeu M, Martinez-Sanchez J, De Moner B, Diaz-Ricart M. Endothelial activation and damage as a common pathological substrate in different pathologies and cell therapy complications. Front Med (Lausanne) 2023; 10:1285898. [PMID: 38034541 PMCID: PMC10682735 DOI: 10.3389/fmed.2023.1285898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
The endothelium is a biologically active interface with multiple functions, some of them common throughout the vascular tree, and others that depend on its anatomical location. Endothelial cells are continually exposed to cellular and humoral factors, and to all those elements (biological, chemical, or hemodynamic) that circulate in blood at a certain time. It can adapt to different stimuli but this capability may be lost if the stimuli are strong enough and/or persistent in time. If the endothelium loses its adaptability it may become dysfunctional, becoming a potential real danger to the host. Endothelial dysfunction is present in multiple clinical conditions, such as chronic kidney disease, obesity, major depression, pregnancy-related complications, septic syndromes, COVID-19, and thrombotic microangiopathies, among other pathologies, but also in association with cell therapies, such as hematopoietic stem cell transplantation and treatment with chimeric antigen receptor T cells. In these diverse conditions, evidence suggests that the presence and severity of endothelial dysfunction correlate with the severity of the associated disease. More importantly, endothelial dysfunction has a strong diagnostic and prognostic value for the development of critical complications that, although may differ according to the underlying disease, have a vascular background in common. Our multidisciplinary team of women has devoted many years to exploring the role of the endothelium in association with the mentioned diseases and conditions. Our research group has characterized some of the mechanisms and also proposed biomarkers of endothelial damage. A better knowledge would provide therapeutic strategies either to prevent or to treat endothelial dysfunction.
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Affiliation(s)
- Marta Palomo
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
- Hematology External Quality Assessment Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ana Belén Moreno-Castaño
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
| | - María Queralt Salas
- Hematopoietic Stem Cell Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, Barcelona, Spain
| | - Silvia Escribano-Serrat
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
| | - Montserrat Rovira
- Hematopoietic Stem Cell Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, Barcelona, Spain
| | - Elena Guillen-Olmos
- Department of Nephrology and Kidney Transplantation, Hospital Clínic de Barcelona, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), University of Barcelona, Barcelona, Spain
| | - Sara Fernandez
- Medical Intensive Care Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Lina Youssef
- BCNatal – Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Clínic de Barcelona and Hospital Sant Joan de Déu, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
- Josep Carreras Leukaemia Research Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Fatima Crispi
- BCNatal – Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Clínic de Barcelona and Hospital Sant Joan de Déu, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Meritxell Nomdedeu
- Hemostasis and Hemotherapy Department, Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Julia Martinez-Sanchez
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
| | - Blanca De Moner
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
- Josep Carreras Leukaemia Research Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Maribel Diaz-Ricart
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
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15
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Betriu S, Rovira J, Arana C, García-Busquets A, Matilla-Martinez M, Ramirez-Bajo MJ, Bañon-Maneus E, Lazo-Rodriguez M, Bartoló-Ibars A, Claas FHJ, Mulder A, Heidt S, Juan M, Bayés-Genís B, Campistol JM, Palou E, Diekmann F. Chimeric HLA antibody receptor T cells for targeted therapy of antibody-mediated rejection in transplantation. HLA 2023; 102:449-463. [PMID: 37503860 DOI: 10.1111/tan.15156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/29/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023]
Abstract
The presence of donor-specific antibodies (DSA), mainly against HLA, increases the risk of allograft rejection. Moreover, antibody-mediated rejection (ABMR) remains an important barrier to optimal long-term outcomes after solid organ transplantation. The development of chimeric autoantibody receptor T lymphocytes has been postulated for targeted therapy of autoimmune diseases. We aimed to develop a targeted therapy for DSA desensitization and ABMR, generating T cells with a chimeric HLA antibody receptor (CHAR) that specifically eliminates DSA-producing B cells. We have genetically engineered an HLA-A2-specific CHAR (A2-CHAR) and transduced it into human T cells. Then, we have performed in vitro experiments such as cytokine measurement, effector cell activation, and cytotoxicity against anti-HLA-A2 antibody-expressing target cells. In addition, we have performed A2-CHAR-Tc cytotoxic assays in an immunodeficient mouse model. A2-CHAR expressing T cells could selectively eliminate HLA-A2 antibody-producing B cells in vitro. The cytotoxic capacity of A2-CHAR expressing T cells mainly depended on Granzyme B release. In the NSG mouse model, A2-CHAR-T cells could identify and eradicate HLA-A2 antibody-producing B cells even when those cells are localized in the bone marrow. This ability is effector:target ratio dependent. CHAR technology generates potent and functional human cytotoxic T cells to target alloreactive HLA class I antibody-producing B cells. Thus, we consider that CHAR technology may be used as a selective desensitization protocol or an ABMR therapy in transplantation.
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Affiliation(s)
- Sergi Betriu
- Department of Immunology, Clinic Barcelona, Barcelona, Spain
| | - Jordi Rovira
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Carolt Arana
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Department of Nephrology and Kidney Transplantation, Institut Clínic de Nefrologia i Urologia (ICNU), Clínic Barcelona, Barcelona, Spain
| | - Ainhoa García-Busquets
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| | - Marina Matilla-Martinez
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| | - Maria J Ramirez-Bajo
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Elisenda Bañon-Maneus
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Lazo-Rodriguez
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| | | | - Frans H J Claas
- Department of Immunology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arend Mulder
- Department of Immunology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sebastiaan Heidt
- Department of Immunology, Leiden University Medical Center, Leiden, The Netherlands
| | - Manel Juan
- Department of Immunology, Clinic Barcelona, Barcelona, Spain
| | - Beatriu Bayés-Genís
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Department of Nephrology and Kidney Transplantation, Institut Clínic de Nefrologia i Urologia (ICNU), Clínic Barcelona, Barcelona, Spain
| | - Josep M Campistol
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Department of Nephrology and Kidney Transplantation, Institut Clínic de Nefrologia i Urologia (ICNU), Clínic Barcelona, Barcelona, Spain
| | - Eduard Palou
- Department of Immunology, Clinic Barcelona, Barcelona, Spain
| | - Fritz Diekmann
- Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundació de Recerca Clinic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Red de Investigación Renal (REDINREN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Nephrology and Kidney Transplantation, Institut Clínic de Nefrologia i Urologia (ICNU), Clínic Barcelona, Barcelona, Spain
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16
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Kim JI, Park MY, Kwon E, Kang HJ, Kang BC. CD19 chimeric antigen receptor T cell therapy in leukemia xenograft mouse: Anti-leukemic efficacy, kinetics, and 4-week single-dose toxicity. Toxicol Appl Pharmacol 2023; 475:116628. [PMID: 37506978 DOI: 10.1016/j.taap.2023.116628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/22/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
CD19 Chimeric antigen receptor T (CAR-T) cell therapy has shown a promising response rate for relapsed/refractory B-cell malignancies. However, serious side effects such as cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome arose in early case reports. Though several preclinical and clinical studies of CAR-T cell therapy have been reported, there is a lack of toxicological assessments. This study was carried out as a preclinical assessment of CD19 CAR-T cell therapy, including the anti-leukemic efficacy, kinetics in peripheral blood, and 4-week single-dose toxicity evaluation in leukemia xenograft mice. Leukemia xenograft mice model was established by injecting 1.0 × 105 cells/mouse of luciferase-labeled human B cell acute lymphoblastic leukemia (B-ALL) cell line via the tail vein, and after 3 days, 2.0 or 4.0 × 106 cells/mouse of CD19 CAR-T cells were injected intravenously. CD19 CAR-T cells showed significant anti-leukemic efficacy, showing inhibition of tumor progression in the bioluminescence-based in-vivo imaging system. In the kinetics study using qPCR, CAR-T cells peaked in peripheral blood on day 60 in males and day 30 in females. In a 4-week single-dose toxicity study, CD19 CAR-T cell injected groups showed no mortality and toxicological signs, or changes in body weight, food/water consumption, hematology, clinical chemistry, organ weights, and histopathology compared to control groups. These results suggested that 4.0 × 106 cells/mouse of CD19 CAR-T cells were effective in B-ALL xenograft mice without serious side effects, so the no-observed adverse effect level (NOAEL) was estimated to be higher than 4.0 × 106 cells/mouse, under the condition examined in the current study.
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Affiliation(s)
- Joo-Il Kim
- Graduate School of Translational Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Mi-Young Park
- Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Euna Kwon
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyoung Jin Kang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Cancer Research Institute, Seoul National University Children's Hospital, Seoul, Korea.
| | - Byeong-Cheol Kang
- Graduate School of Translational Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Biomedical Center for Animal Resource and Development, Seoul National University College of Medicine, Seoul, Republic of Korea; Designed Animal Resource Center, Institute of Green Bio Science Technology, Seoul National University, Pyeongchang-gun, Gangwon-do, Republic of Korea.
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17
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Moazzeni A, Kheirandish M, Khamisipour G, Rahbarizadeh F. Directed targeting of B-cell maturation antigen-specific CAR T cells by bioinformatic approaches: From in-silico to in-vitro. Immunobiology 2023; 228:152376. [PMID: 37058845 DOI: 10.1016/j.imbio.2023.152376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/13/2023] [Accepted: 03/05/2023] [Indexed: 04/16/2023]
Abstract
AIMS Chimeric Antigen Receptor (CAR) T-cell is a breakthrough in cancer immunotherapy. The primary step of successful CAR T cell therapy is designing a specific single-chain fragment variable (scFv). This study aims to verify the designed anti-BCMA (B cell maturation antigen) CAR using bioinformatic techniques with the following experimental evaluations. MAIN METHODS Following the second generation of anti-BCMA CAR designing, the protein structure, function prediction, physicochemical complementarity at the ligand-receptor interface, and biding sites analysis of anti-BCMA CAR construct were confirmed using different modeling and docking server, including Expasy, I-TASSER, HDock, and PyMOL software. To generate CAR T-cells, isolated T cells were transduced. Then, anti-BCMA CAR mRNA and its surface expression were confirmed by real-time -PCR and flow cytometry methods, respectively. To evaluate the surface expression of anti-BCMA CAR, anti-(Fab')2 and anti-CD8 antibodies were employed. Finally, anti-BCMA CAR T cells were co-cultured with BCMA+/- cell lines to assess the expression of CD69 and CD107a as activation and cytotoxicity markers. KEY FINDINGS In-silico results approved the suitable protein folding, perfect orientation, and correct locating of functional domains at the receptor-ligand binding site. The in-vitro results confirmed high expression of scFv (89 ± 1.15% (and CD8α (54 ± 2.88%). The expression of CD69 (91.97 ± 1.7%) and CD107a (92.05 ± 1.29%) were significantly increased, indicating appropriate activation and cytotoxicity. SIGNIFICANCE In-silico studies before experimental assessments are crucial for state-of-art CAR designing. Highly activation and cytotoxicity of anti-BCMA CAR T-cell revealed that our CAR construct methodology would be applicable to define the road map of CAR T cell therapy.
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Affiliation(s)
- Ali Moazzeni
- Immunology Department, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine (IBTO), Tehran, Iran
| | - Maryam Kheirandish
- Immunology Department, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine (IBTO), Tehran, Iran.
| | - Gholamreza Khamisipour
- Department of Hematology, Faculty of Allied Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Fatemeh Rahbarizadeh
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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18
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Moreno-Castaño AB, Fernández S, Ventosa H, Palomo M, Martinez-Sanchez J, Ramos A, Ortiz-Maldonado V, Delgado J, Fernández de Larrea C, Urbano-Ispizua A, Penack O, Nicolás JM, Téllez A, Escolar G, Carreras E, Fernández-Avilés F, Castro P, Diaz-Ricart M. Characterization of the endotheliopathy, innate-immune activation and hemostatic imbalance underlying CAR-T cell toxicities: laboratory tools for an early and differential diagnosis. J Immunother Cancer 2023; 11:jitc-2022-006365. [PMID: 37045474 PMCID: PMC10106034 DOI: 10.1136/jitc-2022-006365] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Chimeric antigen receptor (CAR)-T cell-based immunotherapy constitutes a revolutionary advance for treatment of relapsed/refractory hematological malignancies. Nevertheless, cytokine release and immune effector cell-associated neurotoxicity syndromes are life-threatening toxicities in which the endothelium could be a pathophysiological substrate. Furthermore, differential diagnosis from sepsis, highly incident in these patients, is challenging. Suitable laboratory tools could be determinant for their appropriate management. METHODS Sixty-two patients treated with CAR-T cell immunotherapy for hematological malignancies (n=46 with CD19-positive diseases, n=16 with multiple myeloma) were included. Plasma samples were obtained: before CAR-T cell infusion (baseline); after 24-48 hours; at suspicion of any toxicity onset and 24-48 hours after immunomodulatory treatment. Biomarkers of endothelial dysfunction (soluble vascular cell adhesion molecule 1 (sVCAM-1), soluble TNF receptor 1 (sTNFRI), thrombomodulin (TM), soluble suppression of tumorigenesis-2 factor (ST2), angiopoietin-2 (Ang-2)), innate immunity activation (neutrophil extracellular traps (NETs), soluble C5b-9 (sC5b-9)) and hemostasis/fibrinolysis (von Willebrand Factor antigen (VWF:Ag), ADAMTS-13 (A13), α2-antiplasmin (α2-AP), plasminogen activator inhibitor-1 antigen (PAI-1 Ag)) were measured and compared with those in cohorts of patients with sepsis and healthy donors. RESULTS Patients who developed CAR-T cell toxicities presented increased levels of sVCAM-1, sTNFRI and ST2 at the clinical onset versus postinfusion values. Twenty-four hours after infusion, ST2 levels were good predictors of any CAR-T cell toxicity, and combination of ST2, Ang-2 and NETs differentiated patients requiring intensive care unit admission from those with milder clinical presentations. Association of Ang-2, NETs, sC5b-9, VWF:Ag and PAI-1 Ag showed excellent discrimination between severe CAR-T cell toxicities and sepsis. CONCLUSIONS This study provides relevant contributions to the current knowledge of the CAR-T cell toxicities pathophysiology. Markers of endotheliopathy, innate immunity activation and hemostatic imbalance appear as potential laboratory tools for their prediction, severity and differential diagnosis.
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Affiliation(s)
- Ana Belen Moreno-Castaño
- Hemostasis and Erythropathology Laboratory, Hematopathology, Pathology Department, Biomedical Diagnostic Center (CDB), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sara Fernández
- Intensive Care Unit, Clinical Institute of Medicine and Dermatology (ICMID), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Helena Ventosa
- Intensive Care Unit, Clinical Institute of Medicine and Dermatology (ICMID), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Marta Palomo
- Hematology External Quality Assessment Laboratory, Biomedical Diagnostic Center (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Alex Ramos
- Institut de Recerca Contra la Leucèmia Josep Carreras, Campus Clínic, Barcelona, Spain
| | - Valentín Ortiz-Maldonado
- Hematology Department, Clinical Institute of Hematologic and Oncologic Diseases (ICMHO), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Julio Delgado
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
- Hematology Department, Clinical Institute of Hematologic and Oncologic Diseases (ICMHO), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Carlos Fernández de Larrea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
- Hematology Department, Clinical Institute of Hematologic and Oncologic Diseases (ICMHO), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Alvaro Urbano-Ispizua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
- Hematology Department, Clinical Institute of Hematologic and Oncologic Diseases (ICMHO), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Olaf Penack
- Hematology Department, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - J M Nicolás
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
- Intensive Care Unit, Clinical Institute of Medicine and Dermatology (ICMID), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Adrian Téllez
- Intensive Care Unit, Clinical Institute of Medicine and Dermatology (ICMID), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Gines Escolar
- Hemostasis and Erythropathology Laboratory, Hematopathology, Pathology Department, Biomedical Diagnostic Center (CDB), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Enric Carreras
- Fundación Josep Carreras contra la Leucemia, Josep Carreras Leukaemia Research Institute, Barcelona, Spain
| | - Francesc Fernández-Avilés
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
- Hematology Department, Clinical Institute of Hematologic and Oncologic Diseases (ICMHO), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Pedro Castro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
- Intensive Care Unit, Clinical Institute of Medicine and Dermatology (ICMID), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Maribel Diaz-Ricart
- Hemostasis and Erythropathology Laboratory, Hematopathology, Pathology Department, Biomedical Diagnostic Center (CDB), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
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19
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Systematic Review on CAR-T Cell Clinical Trials Up to 2022: Academic Center Input. Cancers (Basel) 2023; 15:cancers15041003. [PMID: 36831349 PMCID: PMC9954171 DOI: 10.3390/cancers15041003] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
The development of Chimeric Antigen Receptor T cells therapy initiated by the United States and China is still currently led by these two countries with a high number of clinical trials, with Europe lagging in launching its first trials. In this systematic review, we wanted to establish an overview of the production of CAR-T cells in clinical trials around the world, and to understand the causes of this delay in Europe. We particularly focused on the academic centers that are at the heart of research and development of this therapy. We counted 1087 CAR-T cells clinical trials on ClinicalTrials.gov (Research registry ID: reviewregistry1542) on the date of 25 January 2023. We performed a global analysis, before analyzing the 58 European trials, 34 of which sponsored by academic centers. Collaboration between an academic and an industrial player seems to be necessary for the successful development and application for marketing authorization of a CAR-T cell, and this collaboration is still cruelly lacking in European trials, unlike in the leading countries. Europe, still far behind the two leading countries, is trying to establish measures to lighten the regulations surrounding ATMPs and to encourage, through the addition of fundings, clinical trials involving these treatments.
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20
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González-Brito A, Uribe-Herranz M. The potential role of short chain fatty acids improving ex vivo T and CAR-T cell fitness and expansion for cancer immunotherapies. Front Immunol 2023; 14:1083303. [PMID: 36742300 PMCID: PMC9896517 DOI: 10.3389/fimmu.2023.1083303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
Adoptive cell therapies, like tumor-infiltrating lymphocytes or chimeric antigen receptor T cells, have become an important immunotherapeutic approach against cancer. One of the main struggles of T cell immunotherapies is how to obtain the most effective T cell phenotype, persistence, and differentiation potential to infuse into patients. Adjusting the T cell ex vivo cell culture conditions is a key factor to increase and improve the efficacy of cellular immunotherapies. In this review, we have summarized the ex vivo impact of short chain fatty acids, a group of gut microbiota derived metabolites, on T cell culture and expansion for immunotherapies. There is a complex gut microbiota-immune system interaction that can affect antitumor immunotherapy efficacy. Indeed, gut microbiota derived metabolites can modulate different biological functions in the immune system local and systemically.
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Affiliation(s)
- Adrián González-Brito
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic de Barcelona, Barcelona, Spain
| | - Mireia Uribe-Herranz
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic de Barcelona, Barcelona, Spain
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21
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Kekre N, Hay KA, Webb JR, Mallick R, Balasundaram M, Sigrist MK, Clement AM, Nielsen JS, Quizi J, Yung E, Brown SD, Dreolini L, Waller DD, Smazynski J, Gierc NS, Loveless BC, Clark K, Dyer T, Hogg R, McCormick L, Gignac M, Bell S, Chapman DM, Bond D, Yong S, Fung R, Lockyer HM, Hodgson V, Murphy C, Subramanian A, Wiebe E, Yoganathan P, Medynski L, Vaillan DC, Black A, McDiarmid S, Kennah M, Hamelin L, Song K, Narayanan S, Rodrigo JA, Dupont S, Hawrysh T, Presseau J, Thavorn K, Lalu MM, Fergusson DA, Bell JC, Atkins H, Nelson BH, Holt RA. CLIC-01: Manufacture and distribution of non-cryopreserved CAR-T cells for patients with CD19 positive hematologic malignancies. Front Immunol 2022; 13:1074740. [PMID: 36601119 PMCID: PMC9806210 DOI: 10.3389/fimmu.2022.1074740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
Access to commercial CD19 CAR-T cells remains limited even in wealthy countries like Canada due to clinical, logistical, and financial barriers related to centrally manufactured products. We created a non-commercial academic platform for end-to-end manufacturing of CAR-T cells within Canada's publicly funded healthcare system. We report initial results from a single-arm, open-label study to determine the safety and efficacy of in-house manufactured CD19 CAR-T cells (entitled CLIC-1901) in participants with relapsed/refractory CD19 positive hematologic malignancies. Using a GMP compliant semi-automated, closed process on the Miltenyi Prodigy, T cells were transduced with lentiviral vector bearing a 4-1BB anti-CD19 CAR transgene and expanded. Participants underwent lymphodepletion with fludarabine and cyclophosphamide, followed by infusion of non-cryopreserved CAR-T cells. Thirty participants with non-Hodgkin's lymphoma (n=25) or acute lymphoblastic leukemia (n=5) were infused with CLIC-1901: 21 males (70%), median age 66 (range 18-75). Time from enrollment to CLIC-1901 infusion was a median of 20 days (range 15-48). The median CLIC-1901 dose infused was 2.3 × 106 CAR-T cells/kg (range 0.13-3.6 × 106/kg). Toxicity included ≥ grade 3 cytokine release syndrome (n=2) and neurotoxicity (n=1). Median follow-up was 6.5 months. Overall response rate at day 28 was 76.7%. Median progression-free and overall survival was 6 months (95%CI 3-not estimable) and 11 months (95% 6.6-not estimable), respectively. This is the first trial of in-house manufactured CAR-T cells in Canada and demonstrates that administering fresh CLIC-1901 product is fast, safe, and efficacious. Our experience may provide helpful guidance for other jurisdictions seeking to create feasible and sustainable CAR-T cell programs in research-oriented yet resource-constrained settings. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT03765177, identifier NCT03765177.
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Affiliation(s)
- Natasha Kekre
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada,Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada,*Correspondence: Natasha Kekre,
| | - Kevin A. Hay
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada,Terry Fox Laboratory, British Columbia Cancer Research Institute, Vancouver, BC, Canada,Vancouver General Hospital, Leukemia and Bone Marrow Transplant Program of British Columbia, Vancouver, BC, Canada
| | - John R. Webb
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Ranjeeta Mallick
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Miruna Balasundaram
- Canada’s Michael Smith Genome Sciences Centre, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Mhairi K. Sigrist
- Terry Fox Laboratory, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Anne-Marie Clement
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada,Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Julie S. Nielsen
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Jennifer Quizi
- Center for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON, Canada,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Eric Yung
- Canada’s Michael Smith Genome Sciences Centre, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Scott D. Brown
- Canada’s Michael Smith Genome Sciences Centre, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Lisa Dreolini
- Canada’s Michael Smith Genome Sciences Centre, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Daniel D. Waller
- Terry Fox Laboratory, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Julian Smazynski
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Nicole S. Gierc
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Bianca C. Loveless
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Kayla Clark
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Tyler Dyer
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Richard Hogg
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Leah McCormick
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Michael Gignac
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Shanti Bell
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - D. Maria Chapman
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - David Bond
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Siao Yong
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Rachel Fung
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Heather M. Lockyer
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Victoria Hodgson
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Catherine Murphy
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Ana Subramanian
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Evelyn Wiebe
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada
| | - Piriya Yoganathan
- Center for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON, Canada,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Liana Medynski
- Center for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Dominique C. Vaillan
- Center for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON, Canada,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Alice Black
- Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Sheryl McDiarmid
- Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Michael Kennah
- Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Linda Hamelin
- Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Kevin Song
- Vancouver General Hospital, Leukemia and Bone Marrow Transplant Program of British Columbia, Vancouver, BC, Canada
| | - Sujaatha Narayanan
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada,Vancouver General Hospital, Leukemia and Bone Marrow Transplant Program of British Columbia, Vancouver, BC, Canada
| | - Judith A. Rodrigo
- Vancouver General Hospital, Leukemia and Bone Marrow Transplant Program of British Columbia, Vancouver, BC, Canada
| | - Stefany Dupont
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Terry Hawrysh
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Manoj M. Lalu
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Dean A. Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - John C. Bell
- Center for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON, Canada,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Harold Atkins
- Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, ON, Canada,Center for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, Ottawa, ON, Canada,Department of Cellular Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Brad H. Nelson
- Conconi Family Immunotherapy Lab, Trev and Joyce Deeley Research Centre, British Columbia Cancer Research Institute, Victoria, BC, Canada,Department of Biochemistry and Microbiology, University of Victoria, Victoria, BC, Canada,Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Robert A. Holt
- Canada’s Michael Smith Genome Sciences Centre, British Columbia Cancer Research Institute, Vancouver, BC, Canada,Department of Biochemistry and Microbiology, University of Victoria, Victoria, BC, Canada,Department of Molecular Biology & Biochemistry, Simon Fraser University, Burnaby, BC, Canada
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22
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Martinez-Cibrian N, Español-Rego M, Pascal M, Delgado J, Ortiz-Maldonado V. Practical aspects of chimeric antigen receptor T-cell administration: From commercial to point-of-care manufacturing. Front Immunol 2022; 13:1005457. [PMID: 36238283 PMCID: PMC9550897 DOI: 10.3389/fimmu.2022.1005457] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2022] Open
Abstract
Chimeric antigen receptor T-cells targeting the CD19 antigen have achieved impressive results in patients with relapsed/refractory (R/R) B-cell malignancies, leading to their approval in the European Union and other jurisdictions. In Spain, the 100% academic anti-CD19 CART-cell product varnimcabtagene autoleucel (var-cel, ARI-0001 cells) has been extraordinarily approved under the Hospital Exemption clause for the treatment of patients older than 25 years of age with R/R acute lymphoblastic leukaemia. Var-cel has also been granted PRIority MEdicines designation by the European Medicines Agency for the same indication. In this review we reveal some practical aspects related to the preparation and administration of academic point-of-care CART-cell products, using var-cel as an example, and put them into the context of commercial products.
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Affiliation(s)
- Nuria Martinez-Cibrian
- Department of Haematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Marta Español-Rego
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mariona Pascal
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Julio Delgado
- Department of Haematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- *Correspondence: Julio Delgado,
| | - Valentín Ortiz-Maldonado
- Department of Haematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
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23
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Battram AM, Oliver-Caldés A, Suárez-Lledó M, Lozano M, Bosch I Crespo M, Martínez-Cibrián N, Cid J, Moreno DF, Rodríguez-Lobato LG, Urbano-Ispizua A, Fernández de Larrea C. T cells isolated from G-CSF-treated multiple myeloma patients are suitable for the generation of BCMA-directed CAR-T cells. Mol Ther Methods Clin Dev 2022; 26:207-223. [PMID: 35859694 PMCID: PMC9271987 DOI: 10.1016/j.omtm.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/16/2022] [Indexed: 10/29/2022]
Abstract
Autologous cell immunotherapy using B cell maturation antigen (BCMA)-targeted chimeric antigen receptor (CAR)-T cells is an effective novel treatment for multiple myeloma (MM). This therapy has only been used for relapsed and refractory patients, at which stage the endogenous T cells used to produce the CAR-T cells are affected by the immunosuppressive nature of advanced MM and/or side effects of previous therapies. An alternative pool of "fitter" T cells is found in leukocytoapheresis products that are routinely collected to obtain hematopoietic progenitor cells for autologous stem cell transplantation (ASCT) early in the treatment of MM. However, to mobilize the progenitor cells, patients are dosed with granulocyte colony-stimulating factor (G-CSF), which is reported to adversely affect T cell proliferation, function, and differentiation. Here, we aimed to first establish whether G-CSF treatment negatively influences T cell phenotype and to ascertain whether previous exposure of T cells to G-CSF is deleterious for anti-BCMA CAR-T cells. We observed that G-CSF had a minimal impact on T cell phenotype when added in vitro or administered to patients. Moreover, we found that CAR-T cell fitness and anti-tumor activity were unaffected when generated from G-CSF-exposed T cells. Overall, we showed that ASCT apheresis products are a suitable source of T cells for anti-BCMA CAR-T cell manufacture.
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Affiliation(s)
- Anthony M Battram
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Aina Oliver-Caldés
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.,Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
| | - Maria Suárez-Lledó
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.,Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
| | - Miquel Lozano
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy & Hemostasis, ICMHO (Institut Clínic de Malalties Hematològiques i Oncològiques), Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Miquel Bosch I Crespo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Núria Martínez-Cibrián
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.,Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
| | - Joan Cid
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.,Apheresis & Cellular Therapy Unit, Department of Hemotherapy & Hemostasis, ICMHO (Institut Clínic de Malalties Hematològiques i Oncològiques), Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - David F Moreno
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.,Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
| | - Luis Gerardo Rodríguez-Lobato
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.,Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
| | - Alvaro Urbano-Ispizua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.,Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain.,Josep Carreras Leukaemia Research Institute, 08036 Barcelona, Spain.,Department of Haematology, University of Barcelona, 08036 Barcelona, Spain
| | - Carlos Fernández de Larrea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain.,Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic of Barcelona, 08036 Barcelona, Spain.,Department of Haematology, University of Barcelona, 08036 Barcelona, Spain
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24
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Tristán-Manzano M, Maldonado-Pérez N, Justicia-Lirio P, Muñoz P, Cortijo-Gutiérrez M, Pavlovic K, Jiménez-Moreno R, Nogueras S, Carmona MD, Sánchez-Hernández S, Aguilar-González A, Castella M, Juan M, Marañón C, Marchal JA, Benabdellah K, Herrera C, Martin F. Physiological lentiviral vectors for the generation of improved CAR-T cells. Mol Ther Oncolytics 2022; 25:335-349. [PMID: 35694446 PMCID: PMC9163403 DOI: 10.1016/j.omto.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/07/2022] [Indexed: 10/29/2022] Open
Abstract
Anti-CD19 chimeric antigen receptor (CAR)-T cells have achieved impressive outcomes for the treatment of relapsed and refractory B-lineage neoplasms. However, important limitations still remain due to severe adverse events (i.e., cytokine release syndrome and neuroinflammation) and relapse of 40%-50% of the treated patients. Most CAR-T cells are generated using retroviral vectors with strong promoters that lead to high CAR expression levels, tonic signaling, premature exhaustion, and overstimulation, reducing efficacy and increasing side effects. Here, we show that lentiviral vectors (LVs) expressing the transgene through a WAS gene promoter (AW-LVs) closely mimic the T cell receptor (TCR)/CD3 expression kinetic upon stimulation. These AW-LVs can generate improved CAR-T cells as a consequence of their moderate and TCR-like expression profile. Compared with CAR-T cells generated with human elongation factor α (EF1α)-driven-LVs, AW-CAR-T cells exhibited lower tonic signaling, higher proportion of naive and stem cell memory T cells, less exhausted phenotype, and milder secretion of tumor necrosis factor alpha (TNF-α) and interferon (IFN)-ɣ after efficient destruction of CD19+ lymphoma cells, both in vitro and in vivo. Moreover, we also showed their improved efficiency using an in vitro CD19+ pancreatic tumor model. We finally demonstrated the feasibility of large-scale manufacturing of AW-CAR-T cells in guanosine monophosphate (GMP)-like conditions. Based on these data, we propose the use of AW-LVs for the generation of improved CAR-T products.
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Affiliation(s)
- María Tristán-Manzano
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
- LentiStem Biotech, Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
| | - Noelia Maldonado-Pérez
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
| | - Pedro Justicia-Lirio
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
- LentiStem Biotech, Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
| | - Pilar Muñoz
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
- Department of Cellular Biology, Faculty of Sciences, University of Granada, Campus Fuentenueva, 18071 Granada, Spain
| | - Marina Cortijo-Gutiérrez
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
| | - Kristina Pavlovic
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
- Department of Cellular Biology, Faculty of Sciences, University of Granada, Campus Fuentenueva, 18071 Granada, Spain
| | - Rosario Jiménez-Moreno
- Maimonides Institute of Biomedical Research in Córdoba (IMIBIC), Cellular Therapy Unit, Reina Sofia University Hospital, University of Córdoba, 14004 Córdoba, Spain
| | - Sonia Nogueras
- Maimonides Institute of Biomedical Research in Córdoba (IMIBIC), Cellular Therapy Unit, Reina Sofia University Hospital, University of Córdoba, 14004 Córdoba, Spain
| | - M. Dolores Carmona
- Maimonides Institute of Biomedical Research in Córdoba (IMIBIC), Cellular Therapy Unit, Reina Sofia University Hospital, University of Córdoba, 14004 Córdoba, Spain
| | - Sabina Sánchez-Hernández
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
| | - Araceli Aguilar-González
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
- Department of Medicinal and Organic Chemistry, Faculty of Pharmacy, University of Granada, Campus Cartuja, 18071 Granada, Spain
| | - María Castella
- Department of Hematology, ICMHO, Hospital Clínic de Barcelona, Villarroel 170, 08036 Barcelona, Spain
| | - Manel Juan
- Department of Hematology, ICMHO, Hospital Clínic de Barcelona, Villarroel 170, 08036 Barcelona, Spain
| | - Concepción Marañón
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
| | - Juan Antonio Marchal
- Biosanitary Research Institute of Granada (ibs.GRANADA), Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada 18071, Spain
| | - Karim Benabdellah
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
| | - Concha Herrera
- Maimonides Institute of Biomedical Research in Córdoba (IMIBIC), Cellular Therapy Unit, Reina Sofia University Hospital, University of Córdoba, 14004 Córdoba, Spain
| | - Francisco Martin
- Department of Genomic Medicine, Pfizer-University of Granada-Andalusian Regional Government Centre for Genomics and Oncological Research (GENYO), PTS, Avda. de la Ilustración 114, 18016 Granada, Spain
- Departamento de Bioquimica y Biología Molecular 3 e Inmunología, Facultad de Medicina, Universidad de Granada, Avda. de la Investigacion 11, 18071 Granada, Spain
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25
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Ortiz‐Maldonado V, Alonso‐Saladrigues A, Español‐Rego M, Martínez‐Cibrián N, Faura A, Magnano L, Català A, Benítez‐Ribas D, Giné E, Díaz‐Beyá M, Correa JG, Rovira M, Montoro‐Lorite M, Martínez‐Roca A, Rodríguez‐Lobato LG, Cabezón R, Cid J, Lozano M, Garcia‐Rey E, Conde N, Pedrals G, Rozman M, Torrebadell M, Setoain X, Rodríguez S, Esteve J, Pascal M, Urbano‐Ispizua Á, Juan M, Delgado J, Rives S. Results of ARI-0001 CART19 cell therapy in patients with relapsed/refractory CD19-positive acute lymphoblastic leukemia with isolated extramedullary disease. Am J Hematol 2022; 97:731-739. [PMID: 35253928 DOI: 10.1002/ajh.26519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/20/2022] [Accepted: 03/01/2022] [Indexed: 12/18/2022]
Abstract
We evaluated outcomes of 18 patients with isolated extramedullary disease (iEMD) relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL) treated with the CD19-directed CAR T cells ARI-0001 in two centers (adult and pediatric), including patients treated in the CART19-BE-01 trial and the consecutive compassionate use program. iEMD was detected by PET-CT in 78% (14/18), and/or by cerebrospinal fluid analysis in 28% (5/18). Patients received cyclophosphamide and fludarabine followed by 1 × 106 ARI-0001 cells/kg, initially as a single dose (first patient) and later split into three fractions (10%, 30%, and 60%). Cytokine release syndrome (CRS) occurred in 50% (9/18) of patients, with no cases of grade ≥3 CRS, and 1 case (6%) of grade 1 neurotoxicity. Tocilizumab was used in 6% of patients (1/18). Procedure-related mortality was 0% at 2 years. Objective responses were seen in 94% (95% confidence interval [CI]: 73%-99%) of patients, with complete responses (CR) seen in 78% (95% CI: 52%-94%) of them. Progression-free and overall survival were 49% (95% CI: 30%-79%) and 61% (95% CI: 40%-92%) at 2 years. In conclusion, the use of ARI-0001 cells in patients with R/R ALL and iEMD was associated with a safety and efficacy profile that is comparable with what is observed in patients with marrow involvement and in line with other CART19 products.
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26
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Blanco B, Ramírez-Fernández Á, Bueno C, Argemí-Muntadas L, Fuentes P, Aguilar-Sopeña Ó, Gutierrez-Agüera F, Zanetti SR, Tapia-Galisteo A, Díez-Alonso L, Segura-Tudela A, Castellà M, Marzal B, Betriu S, Harwood SL, Compte M, Lykkemark S, Erce-Llamazares A, Rubio-Pérez L, Jiménez-Reinoso A, Domínguez-Alonso C, Neves M, Morales P, Paz-Artal E, Guedan S, Sanz L, Toribio ML, Roda-Navarro P, Juan M, Menéndez P, Álvarez-Vallina L. Overcoming CAR-Mediated CD19 Downmodulation and Leukemia Relapse with T Lymphocytes Secreting Anti-CD19 T-cell Engagers. Cancer Immunol Res 2022; 10:498-511. [PMID: 35362043 DOI: 10.1158/2326-6066.cir-21-0853] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/06/2021] [Accepted: 02/09/2022] [Indexed: 11/16/2022]
Abstract
Chimeric antigen receptor (CAR)-modified T cells have revolutionized the treatment of CD19-positive hematologic malignancies. Although anti-CD19 CAR-engineered autologous T cells can induce remission in patients with B-cell acute lymphoblastic leukemia, a large subset relapse, most of them with CD19-positive disease. Therefore, new therapeutic strategies are clearly needed. Here, we report a comprehensive study comparing engineered T cells either expressing a second-generation anti-CD19 CAR (CAR-T19) or secreting a CD19/CD3-targeting bispecific T-cell engager antibody (STAb-T19). We found that STAb-T19 cells are more effective than CAR-T19 cells at inducing cytotoxicity, avoiding leukemia escape in vitro, and preventing relapse in vivo. We observed that leukemia escape in vitro is associated with rapid and drastic CAR-induced internalization of CD19 that is coupled with lysosome-mediated degradation, leading to the emergence of transiently CD19-negative leukemic cells that evade the immune response of engineered CAR-T19 cells. In contrast, engineered STAb-T19 cells induce the formation of canonical immunologic synapses and prevent the CD19 downmodulation observed in anti-CD19 CAR-mediated interactions. Although both strategies show similar efficacy in short-term mouse models, there is a significant difference in a long-term patient-derived xenograft mouse model, where STAb-T19 cells efficiently eradicated leukemia cells, but leukemia relapsed after CAR-T19 therapy. Our findings suggest that the absence of CD19 downmodulation in the STAb-T19 strategy, coupled with the continued antibody secretion, allows an efficient recruitment of the endogenous T-cell pool, resulting in fast and effective elimination of cancer cells that may prevent CD19-positive relapses frequently associated with CAR-T19 therapies.
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Affiliation(s)
- Belén Blanco
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain.,Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (RICORS, RD21/0017/0029), Madrid, Spain
| | - Ángel Ramírez-Fernández
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Clara Bueno
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (RICORS, RD21/0017/0029), Madrid, Spain.,Josep Carreras Leukemia Research Institute, Barcelona, Spain.,Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Argemí-Muntadas
- Immunotherapy and Cell Engineering Laboratory, Department of Engineering, Aarhus University, Aarhus, Denmark
| | - Patricia Fuentes
- Centro de Biología Molecular Severo Ochoa CSIC-UAM, Madrid, Spain
| | - Óscar Aguilar-Sopeña
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Universidad Complutense, Madrid, Spain.,Lymphocyte Immunobiology Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Francisco Gutierrez-Agüera
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (RICORS, RD21/0017/0029), Madrid, Spain.,Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | | | - Antonio Tapia-Galisteo
- Molecular Immunology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain
| | - Laura Díez-Alonso
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Alejandro Segura-Tudela
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Maria Castellà
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Berta Marzal
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Sergi Betriu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Seandean L Harwood
- Immunotherapy and Cell Engineering Laboratory, Department of Engineering, Aarhus University, Aarhus, Denmark
| | - Marta Compte
- Molecular Immunology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain
| | - Simon Lykkemark
- Immunotherapy and Cell Engineering Laboratory, Department of Engineering, Aarhus University, Aarhus, Denmark
| | - Ainhoa Erce-Llamazares
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Laura Rubio-Pérez
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain.,Chair for Immunology UFV/Merck, Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, Spain
| | - Anaïs Jiménez-Reinoso
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Carmen Domínguez-Alonso
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Maria Neves
- Centro de Biología Molecular Severo Ochoa CSIC-UAM, Madrid, Spain
| | - Pablo Morales
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Estela Paz-Artal
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Department of Immunology, Ophthalmology and ENT, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Sonia Guedan
- Department of Hematology and Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain
| | - Laura Sanz
- Molecular Immunology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain
| | - María L Toribio
- Centro de Biología Molecular Severo Ochoa CSIC-UAM, Madrid, Spain
| | - Pedro Roda-Navarro
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Universidad Complutense, Madrid, Spain.,Lymphocyte Immunobiology Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Manel Juan
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain.,Servei d'Immunologia, Hospital Clínic de Barcelona, Barcelona, Spain.,Plataforma Immunoteràpia Hospital Sant Joan de Déu, Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Pablo Menéndez
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (RICORS, RD21/0017/0029), Madrid, Spain.,Josep Carreras Leukemia Research Institute, Barcelona, Spain.,Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain.,Department of Biomedicine, School of Medicine, Universitat de Barcelona, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Luis Álvarez-Vallina
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain.,Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (RICORS, RD21/0017/0029), Madrid, Spain.,Immunotherapy and Cell Engineering Laboratory, Department of Engineering, Aarhus University, Aarhus, Denmark
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27
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Glienke W, Dragon AC, Zimmermann K, Martyniszyn-Eiben A, Mertens M, Abken H, Rossig C, Altvater B, Aleksandrova K, Arseniev L, Kloth C, Stamopoulou A, Moritz T, Lode HN, Siebert N, Blasczyk R, Goudeva L, Schambach A, Köhl U, Eiz-Vesper B, Esser R. GMP-Compliant Manufacturing of TRUCKs: CAR T Cells targeting GD2 and Releasing Inducible IL-18. Front Immunol 2022; 13:839783. [PMID: 35401506 PMCID: PMC8988144 DOI: 10.3389/fimmu.2022.839783] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/25/2022] [Indexed: 12/04/2022] Open
Abstract
Chimeric antigen receptor (CAR)-engineered T cells can be highly effective in the treatment of hematological malignancies, but mostly fail in the treatment of solid tumors. Thus, approaches using 4th advanced CAR T cells secreting immunomodulatory cytokines upon CAR signaling, known as TRUCKs (“T cells redirected for universal cytokine-mediated killing”), are currently under investigation. Based on our previous development and validation of automated and closed processing for GMP-compliant manufacturing of CAR T cells, we here present the proof of feasibility for translation of this method to TRUCKs. We generated IL-18-secreting TRUCKs targeting the tumor antigen GD2 using the CliniMACS Prodigy® system using a recently described “all-in-one” lentiviral vector combining constitutive anti-GD2 CAR expression and inducible IL-18. Starting with 0.84 x 108 and 0.91 x 108 T cells after enrichment of CD4+ and CD8+ we reached 68.3-fold and 71.4-fold T cell expansion rates, respectively, in two independent runs. Transduction efficiencies of 77.7% and 55.1% was obtained, and yields of 4.5 x 109 and 3.6 x 109 engineered T cells from the two donors, respectively, within 12 days. Preclinical characterization demonstrated antigen-specific GD2-CAR mediated activation after co-cultivation with GD2-expressing target cells. The functional capacities of the clinical-scale manufactured TRUCKs were similar to TRUCKs generated in laboratory-scale and were not impeded by cryopreservation. IL-18 TRUCKs were activated in an antigen-specific manner by co-cultivation with GD2-expressing target cells indicated by an increased expression of activation markers (e.g. CD25, CD69) on both CD4+ and CD8+ T cells and an enhanced release of pro-inflammatory cytokines and cytolytic mediators (e.g. IL-2, granzyme B, IFN-γ, perforin, TNF-α). Manufactured TRUCKs showed a specific cytotoxicity towards GD2-expressing target cells indicated by lactate dehydrogenase (LDH) release, a decrease of target cell numbers, microscopic detection of cytotoxic clusters and detachment of target cells in real-time impedance measurements (xCELLigence). Following antigen-specific CAR activation of TRUCKs, CAR-triggered release IL-18 was induced, and the cytokine was biologically active, as demonstrated in migration assays revealing specific attraction of monocytes and NK cells by supernatants of TRUCKs co-cultured with GD2-expressing target cells. In conclusion, GMP-compliant manufacturing of TRUCKs is feasible and delivers high quality T cell products.
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Affiliation(s)
- Wolfgang Glienke
- ATMP-GMP Development Unit, Institute of Cellular Therapeutics, Integrated Research and Treatment Center for Transplantation, Hannover Medical School, Hannover, Germany
- *Correspondence: Wolfgang Glienke, ; Axel Schambach,
| | - Anna Christina Dragon
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Katharina Zimmermann
- Division of Hematology/Oncology, Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Alexandra Martyniszyn-Eiben
- ATMP-GMP Development Unit, Institute of Cellular Therapeutics, Integrated Research and Treatment Center for Transplantation, Hannover Medical School, Hannover, Germany
| | - Mira Mertens
- ATMP-GMP Development Unit, Institute of Cellular Therapeutics, Integrated Research and Treatment Center for Transplantation, Hannover Medical School, Hannover, Germany
| | - Hinrich Abken
- Leibniz Institute for Immunotherapy, Div Genetic Immunotherapy, Regensburg, Germany
| | - Claudia Rossig
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Muenster, Muenster, Germany
| | - Bianca Altvater
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Muenster, Muenster, Germany
| | - Krasimira Aleksandrova
- Cellular Therapy Center, Institute of Cellular Therapeutics, Hannover Medical School, Hannover, Germany
| | - Lubomir Arseniev
- Cellular Therapy Center, Institute of Cellular Therapeutics, Hannover Medical School, Hannover, Germany
| | - Christina Kloth
- Division of Hematology/Oncology, Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Andriana Stamopoulou
- Division of Hematology/Oncology, Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Thomas Moritz
- Division of Hematology/Oncology, Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Holger N. Lode
- Department of Pediatric Hematology and Oncology, University Medicine Greifswald, Greifswald, Germany
| | - Nikolai Siebert
- Department of Pediatric Hematology and Oncology, University Medicine Greifswald, Greifswald, Germany
| | - Rainer Blasczyk
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Lilia Goudeva
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Axel Schambach
- Division of Hematology/Oncology, Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
- Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- *Correspondence: Wolfgang Glienke, ; Axel Schambach,
| | - Ulrike Köhl
- ATMP-GMP Development Unit, Institute of Cellular Therapeutics, Integrated Research and Treatment Center for Transplantation, Hannover Medical School, Hannover, Germany
- Cellular Therapy Center, Institute of Cellular Therapeutics, Hannover Medical School, Hannover, Germany
- Fraunhofer Institute for Cell Therapy and Immunology (IZI), Leipzig, Germany
- Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Britta Eiz-Vesper
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Ruth Esser
- ATMP-GMP Development Unit, Institute of Cellular Therapeutics, Integrated Research and Treatment Center for Transplantation, Hannover Medical School, Hannover, Germany
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Ramírez-Fernández Á, Aguilar-Sopeña Ó, Díez-Alonso L, Segura-Tudela A, Domínguez-Alonso C, Roda-Navarro P, Álvarez-Vallina L, Blanco B. Synapse topology and downmodulation events determine the functional outcome of anti-CD19 T cell-redirecting strategies. Oncoimmunology 2022; 11:2054106. [PMID: 35355682 PMCID: PMC8959521 DOI: 10.1080/2162402x.2022.2054106] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/23/2022] [Accepted: 03/11/2022] [Indexed: 11/21/2022] Open
Abstract
Cancer immunotherapy strategies based on the endogenous secretion of T cell-redirecting bispecific antibodies by engineered T lymphocytes (STAb-T) are emerging as alternative or complementary approaches to those based on chimeric antigen receptors (CAR-T). The antitumor efficacy of bispecific anti-CD19 × anti-CD3 (CD19×CD3) T cell engager (BiTE)-secreting STAb-T cells has been demonstrated in several mouse models of B-cell acute leukemia. Here, we have investigated the spatial topology and downstream signaling of the artificial immunological synapses (IS) that are formed by CAR-T or STAb-T cells. Upon interaction with CD19-positive target cells, STAb-T cells form IS with structure and signal transduction, which more closely resemble those of physiological cognate IS, compared to IS formed by CAR-T cells expressing a second-generation CAR bearing the same CD19-single-chain variable fragment. Importantly, while CD3 is maintained at detectable levels on the surface of STAb-T cells, indicating sustained activation mediated by the secreted BiTE, the anti-CD19 CAR was rapidly downmodulated, which correlated with a more transient downstream signaling. Furthermore, CAR-T cells, but not STAb-T cells, provoke an acute loss of CD19 in target cells. Such differences might represent advantages of the STAb-T strategy over the CAR-T approach and should be carefully considered in order to develop more effective and safer treatments for hematological malignancies.
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Affiliation(s)
- Ángel Ramírez-Fernández
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital, Universitario 12 de Octubre, Madrid, Spain
- Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Óscar Aguilar-Sopeña
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Universidad Complutense, Madrid, Spain
- Lymphocyte Immunobiology Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Laura Díez-Alonso
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital, Universitario 12 de Octubre, Madrid, Spain
- Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Alejandro Segura-Tudela
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital, Universitario 12 de Octubre, Madrid, Spain
- Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Carmen Domínguez-Alonso
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital, Universitario 12 de Octubre, Madrid, Spain
- Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Pedro Roda-Navarro
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Universidad Complutense, Madrid, Spain
- Lymphocyte Immunobiology Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
| | - Luis Álvarez-Vallina
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital, Universitario 12 de Octubre, Madrid, Spain
- Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (RICORS, RD21/0017/0029), Madrid, Spain
| | - Belén Blanco
- Cancer Immunotherapy Unit (UNICA), Department of Immunology, Hospital, Universitario 12 de Octubre, Madrid, Spain
- Immuno-Oncology and Immunotherapy Group, Instituto de Investigación Sanitaria 12 de Octubre (imas12), Madrid, Spain
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (RICORS, RD21/0017/0029), Madrid, Spain
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29
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González-Casacuberta I, Vilas D, Pont-Sunyer C, Tobías E, Cantó-Santos J, Valls-Roca L, García-García FJ, Garrabou G, Grau-Junyent JM, Martí MJ, Cardellach F, Morén C. Neuronal induction and bioenergetics characterization of human forearm adipose stem cells from Parkinson’s disease patients and healthy controls. PLoS One 2022; 17:e0265256. [PMID: 35290400 PMCID: PMC8923468 DOI: 10.1371/journal.pone.0265256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/26/2022] [Indexed: 11/18/2022] Open
Abstract
Neurodegenerative diseases, such as Parkinson’s disease, are heterogeneous disorders with a multifactorial nature involving impaired bioenergetics. Stem-regenerative medicine and bioenergetics have been proposed as promising therapeutic targets in the neurologic field. The rationale of the present study was to assess the potential of human-derived adipose stem cells (hASCs) to transdifferentiate into neuronal-like cells (NhASCs and neurospheres) and explore the hASC bioenergetic profile. hASC neuronal transdifferentiation was performed through neurobasal media and differentiation factor exposure. High resolution respirometry was assessed. Increased MAP-2 neuronal marker protein expression upon neuronal induction (p<0.05 undifferentiated hASCs vs. 28–36 days of differentiation) and increased bIII-tubulin neuronal marker protein expression upon neuronal induction (p<0.05 undifferentiated hASCs vs. 6-28-36 days of differentiation) were found. The bioenergetic profile was detectable through high-resolution respirometry approaches in hASCs but did not lead to differential oxidative capacity rates in healthy or clinically diagnosed PD-hASCs. We confirmed the capability of transdifferentiation to the neuronal-like profile of hASCs derived from the forearms of human subjects and characterized the bioenergetic profile. Suboptimal maximal respiratory capacity trends in PD were found. Neuronal induction leading to positive neuronal protein expression markers is a relevant issue that encourages the suitability of NhASC models in neurodegeneration.
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Affiliation(s)
- Ingrid González-Casacuberta
- Cellex-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona, Spain
- Internal Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Madrid, Spain
| | - Dolores Vilas
- Neurodegenerative Diseases Unit, Neurology Service, University Hospital Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Claustre Pont-Sunyer
- Neurology Unit, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Catalonia, Spain
| | - Ester Tobías
- Cellex-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona, Spain
- Internal Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Madrid, Spain
| | - Judith Cantó-Santos
- Cellex-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona, Spain
- Internal Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Madrid, Spain
| | - Laura Valls-Roca
- Cellex-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona, Spain
- Internal Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Madrid, Spain
| | - Francesc Josep García-García
- Cellex-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona, Spain
- Internal Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Madrid, Spain
| | - Glòria Garrabou
- Cellex-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona, Spain
- Internal Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Madrid, Spain
| | - Josep Maria Grau-Junyent
- Cellex-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona, Spain
- Internal Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Madrid, Spain
| | - Maria Josep Martí
- Cellex-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona, Spain
- Movement Disorders Unit, Neurology Service, Institut de Neurociències, University of Barcelona, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Catalonia, Spain
| | - Francesc Cardellach
- Cellex-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona, Spain
- Internal Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Madrid, Spain
| | - Constanza Morén
- Cellex-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine and Health Science, University of Barcelona, Spain
- Internal Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Madrid, Spain
- * E-mail:
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30
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Accelerating clinical-scale production of BCMA CAR T cells with defined maturation stages. Mol Ther Methods Clin Dev 2022; 24:181-198. [PMID: 35118163 PMCID: PMC8791860 DOI: 10.1016/j.omtm.2021.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 12/22/2021] [Indexed: 01/04/2023]
Abstract
The advent of CAR T cells targeting CD19 or BCMA on B cell neoplasm demonstrated remarkable efficacy, but rapid relapses and primary refractoriness remains challenging. A leading cause of CAR T cell failure is their lack of expansion and limited persistence. Long-lived, self-renewing multipotent T memory stem cells (TSCM) and T central memory cells (TCM) likely sustain superior tumor regression, but their low frequencies in blood from cancer patients impose a major hurdle for clinical CAR T production. We designed a clinically compliant protocol for generating BCMA CAR T cells starting with increased TSCM/TCM cell input. A CliniMACS Prodigy process was combined with flow cytometry-based enrichment of CD62L+CD95+ T cells. Although starting with only 15% of standard T cell input, the selected TSCM/TCM material was efficiently activated and transduced with a BCMA CAR-encoding retrovirus. Cultivation in the presence of IL-7/IL-15 enabled the harvest of CAR T cells containing an increased CD4+ TSCM fraction and 70% TSCM cells amongst CD8+. Strong cell proliferation yielded cell numbers sufficient for clinical application, while effector functions were maintained. Together, adaptation of a standard CliniMACS Prodigy protocol to low input numbers resulted in efficient retroviral transduction with a high CAR T cell yield.
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31
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Glez-Vaz J, Azpilikueta A, Olivera I, Cirella A, Teijeira A, Ochoa MC, Alvarez M, Eguren-Santamaria I, Luri-Rey C, Rodriguez-Ruiz ME, Nie X, Chen L, Guedan S, Sanamed MF, Luis Perez Gracia J, Melero I. Soluble CD137 as a dynamic biomarker to monitor agonist CD137 immunotherapies. J Immunother Cancer 2022; 10:jitc-2021-003532. [PMID: 35236742 PMCID: PMC8896037 DOI: 10.1136/jitc-2021-003532] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background On the basis of efficacy in mouse tumor models, multiple CD137 (4-1BB) agonist agents are being preclinically and clinically developed. The costimulatory molecule CD137 is inducibly expressed as a transmembrane or as a soluble protein (sCD137). Moreover, the CD137 cytoplasmic signaling domain is a key part in approved chimeric antigen receptors (CARs). Reliable pharmacodynamic biomarkers for CD137 ligation and costimulation of T cells will facilitate clinical development of CD137 agonists in the clinic. Methods We used human and mouse CD8 T cells undergoing activation to measure CD137 transcription and protein expression levels determining both the membrane-bound and soluble forms. In tumor-bearing mice plasma sCD137 concentrations were monitored on treatment with agonist anti-CD137 monoclonal antibodies (mAbs). Human CD137 knock-in mice were treated with clinical-grade agonist anti-human CD137 mAb (Urelumab). Sequential plasma samples were collected from the first patients intratumorally treated with Urelumab in the INTRUST clinical trial. Anti-mesothelin CD137-encompassing CAR-transduced T cells were stimulated with mesothelin coated microbeads. sCD137 was measured by sandwich ELISA and Luminex. Flow cytometry was used to monitor CD137 surface expression. Results CD137 costimulation upregulates transcription and protein expression of CD137 itself including sCD137 in human and mouse CD8 T cells. Immunotherapy with anti-CD137 agonist mAb resulted in increased plasma sCD137 in mice bearing syngeneic tumors. sCD137 induction is also observed in human CD137 knock-in mice treated with Urelumab and in mice transiently humanized with T cells undergoing CD137 costimulation inside subcutaneously implanted Matrigel plugs. The CD137 signaling domain-containing CAR T cells readily released sCD137 and acquired CD137 surface expression on antigen recognition. Patients treated intratumorally with low dose Urelumab showed increased plasma concentrations of sCD137. Conclusion sCD137 in plasma and CD137 surface expression can be used as quantitative parameters dynamically reflecting therapeutic costimulatory activity elicited by agonist CD137-targeted agents.
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Affiliation(s)
- Javier Glez-Vaz
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain
| | - Arantza Azpilikueta
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain
| | - Irene Olivera
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain
| | - Assunta Cirella
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain.,Departments of Immunology-Immunotherapy and Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Alvaro Teijeira
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Maria C Ochoa
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain.,Departments of Immunology-Immunotherapy and Oncology, Clínica Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Maite Alvarez
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain.,Departments of Immunology-Immunotherapy and Oncology, Clínica Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Iñaki Eguren-Santamaria
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain
| | - Carlos Luri-Rey
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain
| | - Maria E Rodriguez-Ruiz
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain.,Departments of Immunology-Immunotherapy and Oncology, Clínica Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Xinxin Nie
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Lieping Chen
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sonia Guedan
- Department of Hematology and Oncology, Hospital Clinic. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Miguel F Sanamed
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain.,Departments of Immunology-Immunotherapy and Oncology, Clínica Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Jose Luis Perez Gracia
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain.,Navarra Institute for Health Research (IDISNA), Pamplona, Spain.,Departments of Immunology-Immunotherapy and Oncology, Clínica Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Ignacio Melero
- Program of Immunology and Immunotherapy, Center for Applied Medical Research (CIMA), Pamplona, Spain .,Navarra Institute for Health Research (IDISNA), Pamplona, Spain.,Departments of Immunology-Immunotherapy and Oncology, Clínica Universidad de Navarra, Pamplona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
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32
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Zanetti SR, Velasco-Hernandez T, Gutierrez-Agüera F, Díaz VM, Romecín PA, Roca-Ho H, Sánchez-Martínez D, Tirado N, Baroni ML, Petazzi P, Torres-Ruiz R, Molina O, Bataller A, Fuster JL, Ballerini P, Juan M, Jeremias I, Bueno C, Menéndez P. A novel and efficient tandem CD19- and CD22-directed CAR for B cell ALL. Mol Ther 2022; 30:550-563. [PMID: 34478871 PMCID: PMC8821938 DOI: 10.1016/j.ymthe.2021.08.033] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/28/2021] [Accepted: 08/25/2021] [Indexed: 02/04/2023] Open
Abstract
CD19-directed chimeric antigen receptor (CAR) T cells have yielded impressive response rates in refractory/relapse B cell acute lymphoblastic leukemia (B-ALL); however, most patients ultimately relapse due to poor CAR T cell persistence or resistance of either CD19+ or CD19- B-ALL clones. CD22 is a pan-B marker whose expression is maintained in both CD19+ and CD19- relapses. CD22-CAR T cells have been clinically used in B-ALL patients, although relapse also occurs. T cells engineered with a tandem CAR (Tan-CAR) containing in a single construct both CD19 and CD22 scFvs may be advantageous in achieving higher remission rates and/or preventing antigen loss. We have generated and functionally validated using cutting-edge assays a 4-1BB-based CD22/CD19 Tan-CAR using in-house-developed novel CD19 and CD22 scFvs. Tan-CAR-expressing T cells showed similar in vitro expansion to CD19-CAR T cells with no increase in tonic signaling. CRISPR-Cas9-edited B-ALL cells confirmed the bispecificity of the Tan-CAR. Tan-CAR was as efficient as CD19-CAR in vitro and in vivo using B-ALL cell lines, patient samples, and patient-derived xenografts (PDXs). Strikingly, the robust antileukemic activity of the Tan-CAR was slightly more effective in controlling the disease in long-term follow-up PDX models. This Tan-CAR construct warrants a clinical appraisal to test whether simultaneous targeting of CD19 and CD22 enhances leukemia eradication and reduces/delays relapse rates and antigen loss.
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Affiliation(s)
- Samanta Romina Zanetti
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,Corresponding author: Samanta Romina Zanetti, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain.
| | - Talia Velasco-Hernandez
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,RICORS-TERAV, ISCIII, Madrid, Spain,Corresponding author: Talia Velasco-Hernández, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain.
| | - Francisco Gutierrez-Agüera
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,RICORS-TERAV, ISCIII, Madrid, Spain
| | - Víctor M. Díaz
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,OneChain Immunotherapeutics S.L., Barcelona, Spain,Faculty of Medicine and Health Sciences, International University of Catalonia, Sant Cugat del Vallès 08195, Spain
| | - Paola Alejandra Romecín
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,RICORS-TERAV, ISCIII, Madrid, Spain
| | - Heleia Roca-Ho
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain
| | - Diego Sánchez-Martínez
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,RICORS-TERAV, ISCIII, Madrid, Spain
| | - Néstor Tirado
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,RICORS-TERAV, ISCIII, Madrid, Spain
| | - Matteo Libero Baroni
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain
| | - Paolo Petazzi
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,RICORS-TERAV, ISCIII, Madrid, Spain
| | - Raúl Torres-Ruiz
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,RICORS-TERAV, ISCIII, Madrid, Spain,Centro Nacional de Investigaciones Oncológicas, Madrid 28029, Spain
| | - Oscar Molina
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,RICORS-TERAV, ISCIII, Madrid, Spain
| | - Alex Bataller
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,Department of Hematology, Hospital Clínic de Barcelona, Barcelona 08036, Spain
| | - José Luis Fuster
- RICORS-TERAV, ISCIII, Madrid, Spain,Sección de Oncohematología Pediátrica, Hospital Virgen de Arrixaca, Murcia 30120, Spain
| | - Paola Ballerini
- Department of Pediatric Hemato-oncology, Hospital Armand Trousseau, Paris 75012, France
| | - Manel Juan
- RICORS-TERAV, ISCIII, Madrid, Spain,Department of Immunology, Hospital Clínic de Barcelona and Hospital Sant Joan de Déu, Barcelona 08950, Spain
| | - Irmela Jeremias
- Department of Apoptosis in Hematopoietic Stem Cells, Helmholtz Center Munich, German Center for Environmental Health (HMGU), Munich 85764, Germany,Department of Pediatrics, Dr von Hauner Children’s Hospital, LMU, Munich 80337, Germany
| | - Clara Bueno
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,RICORS-TERAV, ISCIII, Madrid, Spain,CIBER-ONC, ISCIII, Barcelona, Spain
| | - Pablo Menéndez
- Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain,RICORS-TERAV, ISCIII, Madrid, Spain,CIBER-ONC, ISCIII, Barcelona, Spain,Department of Biomedicine, School of Medicine, University of Barcelona, Barcelona 08036, Spain,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain,Corresponding author: Pablo Menéndez, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, Carrer Casanova 143, 4° floor, Barcelona 08036, Spain.
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33
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Ortiz-Maldonado V, Frigola G, Español-Rego M, Balagué O, Martínez-Cibrián N, Magnano L, Giné E, Pascal M, Correa JG, Martínez-Roca A, Cid J, Lozano M, Villamor N, Benítez-Ribas D, Esteve J, López-Guillermo A, Campo E, Urbano-Ispizua Á, Juan M, Delgado J. Results of ARI-0001 CART19 Cells in Patients With Chronic Lymphocytic Leukemia and Richter’s Transformation. Front Oncol 2022; 12:828471. [PMID: 35174095 PMCID: PMC8841853 DOI: 10.3389/fonc.2022.828471] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/12/2022] [Indexed: 12/11/2022] Open
Abstract
CART19 cells are emerging as an alternative therapy for patients with chronic lymphocytic leukemia (CLL). Here we report the outcome of nine consecutive patients with CLL treated with ARI-0001 CART19 cells, six of them with Richter’s transformation (RT). One patient with RT never received therapy. The cytokine release syndrome rate was 87.5% (12.5% grade ≥3). Neurotoxicity was not observed in any patient. All patients experienced absolute B-cell aplasia, and seven (87.5%) responded to therapy. With a median follow-up of 5.6 months, two patients with RT experienced a CD19-negative relapse. In conclusion, ARI-0001 cell therapy was feasible, safe, and effective in patients with high-risk CLL or RT.
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Affiliation(s)
- Valentín Ortiz-Maldonado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gerard Frigola
- Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marta Español-Rego
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Olga Balagué
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Laura Magnano
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Eva Giné
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Mariona Pascal
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Juan G. Correa
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Joan Cid
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Apheresis & Cell Therapy Unit, Department of Hemotherapy and Hemostasis, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Miquel Lozano
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Apheresis & Cell Therapy Unit, Department of Hemotherapy and Hemostasis, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Neus Villamor
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
- Hematopathology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Daniel Benítez-Ribas
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Jordi Esteve
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Stem Cell Transplant and Cell Immunotherapy Group, Institute of Research Josep Carreras, Barcelona, Spain
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Elías Campo
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Hematopathology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Álvaro Urbano-Ispizua
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Stem Cell Transplant and Cell Immunotherapy Group, Institute of Research Josep Carreras, Barcelona, Spain
| | - Manel Juan
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- *Correspondence: Julio Delgado,
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Buechner J, Caruana I, Künkele A, Rives S, Vettenranta K, Bader P, Peters C, Baruchel A, Calkoen FG. Chimeric Antigen Receptor T-Cell Therapy in Paediatric B-Cell Precursor Acute Lymphoblastic Leukaemia: Curative Treatment Option or Bridge to Transplant? Front Pediatr 2022; 9:784024. [PMID: 35145941 PMCID: PMC8823293 DOI: 10.3389/fped.2021.784024] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/02/2021] [Indexed: 01/02/2023] Open
Abstract
Chimeric antigen receptor T-cell therapy (CAR-T) targeting CD19 has been associated with remarkable responses in paediatric patients and adolescents and young adults (AYA) with relapsed/refractory (R/R) B-cell precursor acute lymphoblastic leukaemia (BCP-ALL). Tisagenlecleucel, the first approved CD19 CAR-T, has become a viable treatment option for paediatric patients and AYAs with BCP-ALL relapsing repeatedly or after haematopoietic stem cell transplantation (HSCT). Based on the chimeric antigen receptor molecular design and the presence of a 4-1BB costimulatory domain, tisagenlecleucel can persist for a long time and thereby provide sustained leukaemia control. "Real-world" experience with tisagenlecleucel confirms the safety and efficacy profile observed in the pivotal registration trial. Recent guidelines for the recognition, management and prevention of the two most common adverse events related to CAR-T - cytokine release syndrome and immune-cell-associated neurotoxicity syndrome - have helped to further decrease treatment toxicity. Consequently, the questions of how and for whom CD19 CAR-T could substitute HSCT in BCP-ALL are inevitable. Currently, 40-50% of R/R BCP-ALL patients relapse post CD19 CAR-T with either CD19- or CD19+ disease, and consolidative HSCT has been proposed to avoid disease recurrence. Contrarily, CD19 CAR-T is currently being investigated in the upfront treatment of high-risk BCP-ALL with an aim to avoid allogeneic HSCT and associated treatment-related morbidity, mortality and late effects. To improve survival and decrease long-term side effects in children with BCP-ALL, it is important to define parameters predicting the success or failure of CAR-T, allowing the careful selection of candidates in need of HSCT consolidation. In this review, we describe the current clinical evidence on CAR-T in BCP-ALL and discuss factors associated with response to or failure of this therapy: product specifications, patient- and disease-related factors and the impact of additional therapies given before (e.g., blinatumomab and inotuzumab ozogamicin) or after infusion (e.g., CAR-T re-infusion and/or checkpoint inhibition). We discuss where to position CAR-T in the treatment of BCP-ALL and present considerations for the design of supportive trials for the different phases of disease. Finally, we elaborate on clinical settings in which CAR-T might indeed replace HSCT.
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Affiliation(s)
- Jochen Buechner
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
| | - Ignazio Caruana
- Department of Paediatric Haematology, Oncology and Stem Cell Transplantation, University Hospital Würzburg, Würzburg, Germany
| | - Annette Künkele
- Department of Pediatric Oncology and Hematology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Susana Rives
- Department of Pediatric Hematology and Oncology, Hospital Sant Joan de Déu de Barcelona, Institut per la Recerca Sant Joan de Déu, Barcelona, Spain
| | - Kim Vettenranta
- University of Helsinki and Children's Hospital, University of Helsinki, Helsinki, Finland
| | - Peter Bader
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital, Goethe University, Frankfurt, Germany
| | - Christina Peters
- St. Anna Children's Hospital, Medical University Vienna, Vienna, Austria
- St. Anna Children's Cancer Research Institute, Vienna, Austria
| | - André Baruchel
- Université de Paris et Institut de Recherche Saint-Louis (EA 35-18) and Hôpital Universitaire Robert Debré (APHP), Paris, France
| | - Friso G. Calkoen
- Department of Stem Cell Transplantation and Cellular Therapy, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
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35
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Trias E, Juan M, Urbano-Ispizua A, Calvo G. The hospital exemption pathway for the approval of advanced therapy medicinal products: an underused opportunity? The case of the CAR-T ARI-0001. Bone Marrow Transplant 2022; 57:156-159. [PMID: 35046545 PMCID: PMC8821008 DOI: 10.1038/s41409-021-01463-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/24/2021] [Accepted: 09/03/2021] [Indexed: 11/25/2022]
Abstract
In February 2021, the ‘Advanced Therapy Medicinal Product’ (ATMP) ARI-0001 (CART19-BE-01), developed at Hospital Clínic de Barcelona (Spain), received authorization from the Spanish Agency of Medicines and Medical Devices (AEMPS) under the ‘hospital exemption’ (HE) approval pathway for the treatment of patients aged >25 years with relapsed/refractory (RR) acute lymphoblastic leukemia (ALL). The HE pathway foreseen by the European Regulation establishing the legal framework for ATMPs intended to be placed on the market in the EU, allows access to ATMPs prepared on a non-routine basis, according to quality standards, like a custom-made product for an individual patient. Its use is limited to the same Member State where it was developed, in a hospital under the responsibility of a medical practitioner. HE-ATMPs must comply with national traceability and pharmacovigilance requirements and specific quality standards. HE offers an opportunity to develop ATMPs in close contact with clinical practice, with the quality and rapid access needed by patients and at a lower cost compared to regular market authorization. However, many barriers need to be overcome. Here we discuss relevant aspects of the development and authorization of ARI-0001 in the context of the heterogeneous frame of the European Regulation implementation across the Member States.
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36
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Billingsley MM, Hamilton AG, Mai D, Patel SK, Swingle KL, Sheppard NC, June CH, Mitchell MJ. Orthogonal Design of Experiments for Optimization of Lipid Nanoparticles for mRNA Engineering of CAR T Cells. NANO LETTERS 2022; 22:533-542. [PMID: 34669421 PMCID: PMC9335860 DOI: 10.1021/acs.nanolett.1c02503] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Viral engineered chimeric antigen receptor (CAR) T cell therapies are potent, targeted cancer immunotherapies, but their permanent CAR expression can lead to severe adverse effects. Nonviral messenger RNA (mRNA) CAR T cells are being explored to overcome these drawbacks, but electroporation, the most common T cell transfection method, is limited by cytotoxicity. As a potentially safer nonviral delivery strategy, here, sequential libraries of ionizable lipid nanoparticle (LNP) formulations with varied excipient compositions were screened in comparison to a standard formulation for improved mRNA delivery to T cells with low cytotoxicity, revealing B10 as the top formulation with a 3-fold increase in mRNA delivery. When compared to electroporation in primary human T cells, B10 LNPs induced comparable CAR expression with reduced cytotoxicity while demonstrating potent cancer cell killing. These results demonstrate the impact of excipient optimization on LNP performance and support B10 LNPs as a potent mRNA delivery platform for T cell engineering.
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Affiliation(s)
- Margaret M Billingsley
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Alex G Hamilton
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - David Mai
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Savan K Patel
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Kelsey L Swingle
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Neil C Sheppard
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Carl H June
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Michael J Mitchell
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Institute for Regenerative Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
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37
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Ortiz-Maldonado V, Rives S, Español-Rego M, Alonso-Saladrigues A, Montoro M, Magnano L, Giné E, Pascal M, Díaz-Beyá M, Castella M, Català A, Faura A, Rodríguez-Lobato LG, Oliver-Caldes A, Martínez-Roca A, Rovira M, González-Navarro EA, Ortega JR, Cid J, Lozano M, Garcia-Rey E, Fernández S, Castro P, Jordan I, Villamor N, Aymerich M, Torrebadell M, Deyà À, Fernández de Larrea C, Benitez-Ribas D, Trias E, Varea S, Calvo G, Esteve J, Urbano-Ispizua A, Juan M, Delgado J. Factors associated with the clinical outcome of patients with relapsed/refractory CD19 + acute lymphoblastic leukemia treated with ARI-0001 CART19-cell therapy. J Immunother Cancer 2021; 9:jitc-2021-003644. [PMID: 34907029 PMCID: PMC8671976 DOI: 10.1136/jitc-2021-003644] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Valentín Ortiz-Maldonado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Susana Rives
- Department of Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, Barcelona, Spain.,Institut de Recerca Pediàtrica Sant Joan de Déu, Barcelona, Spain
| | - Marta Español-Rego
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Anna Alonso-Saladrigues
- Department of Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Mercedes Montoro
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Laura Magnano
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Eva Giné
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain
| | - Mariona Pascal
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marina Díaz-Beyá
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Albert Català
- Department of Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, Barcelona, Spain.,Institut de Recerca Pediàtrica Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, Madrid, Spain
| | - Anna Faura
- Department of Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Luis Gerardo Rodríguez-Lobato
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Aina Oliver-Caldes
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Montserrat Rovira
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Juan Ramón Ortega
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Joan Cid
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Apheresis & Cell Therapy Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Miquel Lozano
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Apheresis & Cell Therapy Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | | | - Sara Fernández
- Medical Intensive Care Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Pedro Castro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Medical Intensive Care Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Iolanda Jordan
- Institut de Recerca Pediàtrica Sant Joan de Déu, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Neus Villamor
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain.,Hematopathology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marta Aymerich
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Hematopathology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Montserrat Torrebadell
- Institut de Recerca Pediàtrica Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, Madrid, Spain.,Laboratory of Hematology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Àngela Deyà
- Clinical Immunology and Primary Immunodeficiencies Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carlos Fernández de Larrea
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Daniel Benitez-Ribas
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Esteve Trias
- Advanced Therapies Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sara Varea
- Department of Clinical Pharmacology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Gonzalo Calvo
- Advanced Therapies Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Department of Clinical Pharmacology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Jordi Esteve
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | - Alvaro Urbano-Ispizua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | - Manel Juan
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain .,Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain.,Clinical Immunology Platform, Hospital Clínic-Sant Joan de Déu, Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain .,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
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38
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Ramos RN, Picanço-Castro V, Oliveira TGM, Mendrone A, De Santis GC, Bonamino MH, Rocha V. Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Consensus on genetically modified cells. VII. Present and future of technologies for production of CAR cell therapies. Hematol Transfus Cell Ther 2021; 43 Suppl 2:S46-S53. [PMID: 34794797 PMCID: PMC8606694 DOI: 10.1016/j.htct.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/14/2021] [Indexed: 11/28/2022] Open
Abstract
Chimeric Antigen Receptor T (CAR-T) cells are certainly an important therapy for patients with relapsed and/or refractory hematologic malignancies. Currently, there are five CAR-T cell products approved by the FDA but several research groups and/or biopharmaceutical companies are encouraged to develop new products based on CAR cells using T or other cell types. Production of CAR cells requires intensive work from the basic, pre-clinical to translational levels, aiming to overcome technical difficulties and failure in the production. At least five key common steps are needed for the manipulation of T-lymphocytes (or other cells), such as: cell type selection, activation, gene delivery, cell expansion and final product formulation. However, reproducible manufacturing of high-quality clinical-grade CAR cell products is still required to apply this technology to a greater number of patients. This chapter will discuss the present and future development of new CAR designs that are safer and more effective to improve this therapy, achieving more selective killing of malignant cells and less toxicity to be applied in the clinical setting.
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Affiliation(s)
- Rodrigo Nalio Ramos
- Laboratório de Investigação Médica em Patogênese e Terapia dirigida em Onco-Imuno-Hematologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil; Instituto D'Or de Ensino e Pesquisa, São Paulo, Brazil
| | - Virginia Picanço-Castro
- Fundação Hemocentro de Ribeirão Preto, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, (HC FMRPUSP) Ribeirão Preto, SP, Brazil
| | - Theo Gremen M Oliveira
- Laboratório de Investigação Médica em Patogênese e Terapia dirigida em Onco-Imuno-Hematologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil; Fundação Pró-Sangue-Hemocentro de São Paulo, São Paulo, Brazil
| | | | - Gil Cunha De Santis
- Fundação Hemocentro de Ribeirão Preto, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, (HC FMRPUSP) Ribeirão Preto, SP, Brazil
| | - Martin Hernan Bonamino
- Divisão de Pesquisa Experimental e Translacional, Instituto Nacional do Câncer (INCA), Rio de Janeiro, RJ, Brazil; Vice-Presidência de Pesquisa e Coleções Biológicas da Fundação Oswaldo Cruz ((VPPCB FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Vanderson Rocha
- Laboratório de Investigação Médica em Patogênese e Terapia dirigida em Onco-Imuno-Hematologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil; Instituto D'Or de Ensino e Pesquisa, São Paulo, Brazil; Fundação Pró-Sangue-Hemocentro de São Paulo, São Paulo, Brazil.
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Rampotas A, Sangha G, Collins GP. Integration of cell therapies and bispecific antibodies into the treatment pathway of relapsed diffuse large B-cell lymphoma. Ther Adv Hematol 2021; 12:20406207211053120. [PMID: 34733463 PMCID: PMC8558790 DOI: 10.1177/20406207211053120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Gina Sangha
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Graham P Collins
- Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, UK
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Bartoló-Ibars A, Uribe-Herranz M, Muñoz-Sánchez G, Arnaldos-Pérez C, Ortiz-Maldonado V, Urbano-Ispizua Á, Pascal M, Juan M. CAR-T after Stem Cell Transplantation in B-Cell Lymphoproliferative Disorders: Are They Really Autologous or Allogenic Cell Therapies? Cancers (Basel) 2021; 13:4664. [PMID: 34572890 PMCID: PMC8470158 DOI: 10.3390/cancers13184664] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 09/13/2021] [Indexed: 12/20/2022] Open
Abstract
Allogenic hematopoietic stem cell transplantation (allo-HSCT) is one of the standard treatments for B-cell lymphoproliferative disorders; however, deep relapses are common after an allo-HSCT, and it is associated with poor prognosis. A successful approach to overcome these relapses is to exploit the body's own immune system with chimeric antigen receptor (CAR) T-cells. These two approaches are potentially combinatorial for treating R/R B-cell lymphoproliferative disorders. Several clinical trials have described different scenarios in which allo-HSCT and CAR-T are successively combined. Further, for all transplanted patients, assessment of chimerism is important to evaluate the engraftment success. Nonetheless, for those patients who previously received an allo-HSCT there is no monitorization of chimerism before manufacturing CAR T-cells. In this review, we focus on allo-HSCT and CAR-T treatments and the different sources of T-cells for manufacturing CAR T-cells.
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Affiliation(s)
- Ariadna Bartoló-Ibars
- Immunology Service—CDB, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (A.B.-I.); (G.M.-S.); (C.A.-P.); (M.P.)
| | - Mireia Uribe-Herranz
- Institut d’ Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic de Barcelona, 08036 Barcelona, Spain; (M.U.-H.); (Á.U.-I.)
| | - Guillermo Muñoz-Sánchez
- Immunology Service—CDB, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (A.B.-I.); (G.M.-S.); (C.A.-P.); (M.P.)
| | - Cristina Arnaldos-Pérez
- Immunology Service—CDB, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (A.B.-I.); (G.M.-S.); (C.A.-P.); (M.P.)
| | | | - Álvaro Urbano-Ispizua
- Institut d’ Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic de Barcelona, 08036 Barcelona, Spain; (M.U.-H.); (Á.U.-I.)
- Hematology Service—ICMHO, Hospital Clínic de Barcelona, 08036 Barcelona, Spain;
- Faculty of Medicine, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Mariona Pascal
- Immunology Service—CDB, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (A.B.-I.); (G.M.-S.); (C.A.-P.); (M.P.)
- Institut d’ Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic de Barcelona, 08036 Barcelona, Spain; (M.U.-H.); (Á.U.-I.)
- Faculty of Medicine, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Manel Juan
- Immunology Service—CDB, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (A.B.-I.); (G.M.-S.); (C.A.-P.); (M.P.)
- Institut d’ Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic de Barcelona, 08036 Barcelona, Spain; (M.U.-H.); (Á.U.-I.)
- Faculty of Medicine, Universitat de Barcelona, 08036 Barcelona, Spain
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41
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Zanetti SR, Romecin PA, Vinyoles M, Juan M, Fuster JL, Cámos M, Querol S, Delgado M, Menendez P. Bone marrow MSC from pediatric patients with B-ALL highly immunosuppress T-cell responses but do not compromise CD19-CAR T-cell activity. J Immunother Cancer 2021; 8:jitc-2020-001419. [PMID: 32868394 PMCID: PMC7462245 DOI: 10.1136/jitc-2020-001419] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2020] [Indexed: 01/12/2023] Open
Abstract
Background Although adoptive transfer of CD19-directed chimeric antigen receptor (CAR) T-cells (CD19-CAR T-cells) achieves high rates of complete response in patients with B-cell acute lymphoblastic leukemia (B-ALL), relapse is common. Bone marrow (BM) mesenchymal stem/stromal cells (BM-MSC) are key components of the hematopoietic niche and are implicated in B-ALL pathogenesis and therapy resistance. MSC exert an immunosuppressive effect on T-cells; however, their impact on CD19-CAR T-cell activity is understudied. Methods We performed a detailed characterization of BM-MSC from pediatric patients with B-ALL (B-ALL BM-MSC), evaluated their immunomodulatory properties and their impact on CD19-CAR T-cell activity in vitro using microscopy, qRT-PCR, ELISA, flow cytometry analysis and in vivo using a preclinical model of severe colitis and a B-ALL xenograft model. Results While B-ALL BM-MSC were less proliferative than those from age-matched healthy donors (HD), the morphology, immunophenotype, differentiation potential and chemoprotection was very similar. Likewise, both BM-MSC populations were equally immunosuppressive in vitro and anti-inflammatory in an in vivo model of severe colitis. Interestingly, BM-MSC failed to impair CD19-CAR T-cell cytotoxicity or cytokine production in vitro using B-ALL cell lines and primary B-ALL cells. Finally, the growth of NALM6 cells was controlled in vivo by CD19-CAR T-cells irrespective of the absence/presence of BM-MSC. Conclusions Collectively, our data demonstrate that pediatric B-ALL and HD BM-MSC equally immunosuppress T-cell responses but do not compromise CD19-CAR T-cell activity.
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Affiliation(s)
| | | | | | - Manel Juan
- Servicio de Inmunología, Hospital Clínico de Barcelona, Hospital Clínico de Barcelona, Barcelona, Spain
| | - José Luis Fuster
- Sección de Oncohematología Pediátrica, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.,Instituto Murciano de Investigación biosanitaria, Murcia, Spain
| | - Mireia Cámos
- Hematology Laboratory, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Institut de Recerca Hospital Sant Joan de Déu Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Barcelona, Spain
| | | | - Mario Delgado
- Instituto de Parasitología y Biomedicina López-Neyra-CSIC, Barcelona, Spain
| | - Pablo Menendez
- Josep Carreras Leukemia Research Institute, Barcelona, Spain .,Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Barcelona, Spain
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Bachiller M, Perez-Amill L, Battram AM, Carné SC, Najjar A, Verhoeyen E, Juan M, Urbano-Ispizua A, Martin-Antonio B. NK cells enhance CAR-T cell antitumor efficacy by enhancing immune/tumor cells cluster formation and improving CAR-T cell fitness. J Immunother Cancer 2021; 9:jitc-2021-002866. [PMID: 34433634 PMCID: PMC8388291 DOI: 10.1136/jitc-2021-002866] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Chimeric antigen receptor (CAR)-T cell immunotherapy has modified the concept of treatment in hematological malignancies. In comparison with pediatric patients, where responses are maintained over many years, older patients, such as those with non-Hodgkin's lymphoma (NHL) and multiple myeloma (MM), present lower persistence of CAR-T cells that might be due to decreased fitness of T cells acquired with aging. Moreover, cord blood derived-NK cells (CB-NKs) and CAR-NK cells derived from CB-NK can be used 'off-the-shelf' as immune cells with antitumor properties for the treatment of cancer patients. However, to date, clinical studies have only demonstrated the safety of these therapies but not optimal efficacy. To confront the shortcomings of each therapy, we devised a novel approach consisting of simultaneous (CAR-)NK cell and CAR-T cell administration. In this setting, NK cells demonstrate an important immunoregulation of T cells that could be exploited to enhance the efficacy of CAR-T cells. METHODS A combinatorial treatment based on either CAR-T and CAR-NK cells or CB-NK and CAR-T cells in two models of NHL and MM was performed. Antitumor efficacy was analyzed in vitro and in vivo, and parameters related to early activation, exhaustion and senescence of T cells were analyzed. RESULTS We show that CAR-NK cells derived from CB-NK are only effective at high doses (high E:T ratio) and that their activity rapidly decreases over time in comparison with CAR-T cells. In comparison and to exploit the potential of 'off-the-shelf' CB-NK, we demonstrate that a low number of CB-NK in the CAR-T cell product promotes an early activation of CAR-T cells and their migration to MM cells leading to enhanced anti-MM efficacy. Moreover, cytokines related to CRS development were not increased, and importantly, CB-NK enhanced the fitness of both CARpos and CARneg T cells, promoting lower levels of exhaustion and senescence. CONCLUSION This study demonstrates a relevant immunoregulatory role of CB-NK collaborating with CAR-T cells to enhance their antitumor activity. A novel and different approach to consider in CAR-T cell immunotherapy studies is presented here with the goal to enhance the efficacy of the treatment.
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Affiliation(s)
- Mireia Bachiller
- Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | | | | | | | - Amer Najjar
- Department of Pediatrics-Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Els Verhoeyen
- CIRI, Université de Lyon, INSERM U1111, ENS de Lyon, Université Lyon 1, Lyon, France.,Université Côte d'Azur, INSERM, Nice, France
| | - Manel Juan
- Department of Immunology, Hospital Clinic de Barcelona (HCB), Platforms of Immunoterapy IDIBAPS HSJD-HCB and BST-HCB, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Catalunya, Spain
| | - Alvaro Urbano-Ispizua
- Department of Hematology. University of Barcelona, IDIBAPS, Barcelona, Spain.,Josep Carreras Leukaemia Research Institute, Barcelona, Spain
| | - Beatriz Martin-Antonio
- Department of Experimental Hematology, Instituto de Investigación Sanitaria-Fundación Jiménez Diaz, Madrid, Spain
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Quintarelli C, Guercio M, Manni S, Boffa I, Sinibaldi M, Di Cecca S, Caruso S, Abbaszadeh Z, Camera A, Cembrola B, Ciccone R, Orfao A, Martin-Martin L, Gutierrez-Herrero S, Herrero-Garcia M, Cazzaniga G, Nunes V, Songia S, Marcatili P, Marin FI, Ruella M, Bertaina V, Vinti L, Del Bufalo F, Algeri M, Merli P, De Angelis B, Locatelli F. Strategy to prevent epitope masking in CAR.CD19+ B-cell leukemia blasts. J Immunother Cancer 2021; 9:jitc-2020-001514. [PMID: 34135100 PMCID: PMC8211055 DOI: 10.1136/jitc-2020-001514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
Chimeric antigen receptor T-cells (CAR T-cells) for the treatment of relapsing/refractory B-cell precursor acute lymphoblastic leukemia have led to exciting clinical results. However, CAR T-cell approaches revealed a potential risk of CD19-/CAR+ leukemic relapse due to inadvertent transduction of leukemia cells.
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Affiliation(s)
- Concetta Quintarelli
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy .,Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Marika Guercio
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Simona Manni
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Iolanda Boffa
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Matilde Sinibaldi
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Stefano Di Cecca
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Simona Caruso
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Zeinab Abbaszadeh
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Antonio Camera
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Biancamaria Cembrola
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Roselia Ciccone
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Alberto Orfao
- Translational Program, Cancer Research Centre (IBMCC, USAL-CSIC), Institute for Biomedical Research of Salamanca (IBSAL), CIBERONC and Department of Medicine and Cytometry Service (NUCLEUS Research Support Platform), University of Salamanca (USAL), Salamanca, Spain
| | - Lourdes Martin-Martin
- Translational Program, Cancer Research Centre (IBMCC, USAL-CSIC), Institute for Biomedical Research of Salamanca (IBSAL), CIBERONC and Department of Medicine and Cytometry Service (NUCLEUS Research Support Platform), University of Salamanca (USAL), Salamanca, Spain
| | - Sara Gutierrez-Herrero
- Translational Program, Cancer Research Centre (IBMCC, USAL-CSIC), Institute for Biomedical Research of Salamanca (IBSAL), CIBERONC and Department of Medicine and Cytometry Service (NUCLEUS Research Support Platform), University of Salamanca (USAL), Salamanca, Spain
| | - Maria Herrero-Garcia
- Translational Program, Cancer Research Centre (IBMCC, USAL-CSIC), Institute for Biomedical Research of Salamanca (IBSAL), CIBERONC and Department of Medicine and Cytometry Service (NUCLEUS Research Support Platform), University of Salamanca (USAL), Salamanca, Spain
| | - Gianni Cazzaniga
- Centro Ricerca Tettamanti, Pediatric Department, Fondazione MBBM, University of Milan-Bicocca, Monza, Italy
| | - Vittorio Nunes
- Centro Ricerca Tettamanti, Pediatric Department, Fondazione MBBM, University of Milan-Bicocca, Monza, Italy
| | - Simona Songia
- Centro Ricerca Tettamanti, Pediatric Department, Fondazione MBBM, University of Milan-Bicocca, Monza, Italy
| | - Paolo Marcatili
- Department of Bio and Health Informatics, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Frederikke I Marin
- Department of Bio and Health Informatics, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Marco Ruella
- Department of Pathology and Laboratory Medicine, Abramson Cancer Center, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Valentina Bertaina
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Luciana Vinti
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Francesca Del Bufalo
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Mattia Algeri
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Pietro Merli
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Biagio De Angelis
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Franco Locatelli
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.,Department of Pediatrics, Sapienza University of Rome, Rome, Italy
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Miao L, Zhang Z, Ren Z, Tang F, Li Y. Obstacles and Coping Strategies of CAR-T Cell Immunotherapy in Solid Tumors. Front Immunol 2021; 12:687822. [PMID: 34093592 PMCID: PMC8170155 DOI: 10.3389/fimmu.2021.687822] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/04/2021] [Indexed: 12/31/2022] Open
Abstract
Chimeric antigen receptor (CAR) T-cell immunotherapy refers to an adoptive immunotherapy that has rapidly developed in recent years. It is a novel type of treatment that enables T cells to express specific CARs on their surface, then returns these T cells to tumor patients to kill the corresponding tumor cells. Significant strides in CAR-T cell immunotherapy against hematologic malignancies have elicited research interest among scholars in the treatment of solid tumors. Nonetheless, in contrast with the efficacy of CAR-T cell immunotherapy in the treatment of hematologic malignancies, its general efficacy against solid tumors is insignificant. This has been attributed to the complex biological characteristics of solid tumors. CAR-T cells play a better role in solid tumors, for instance by addressing obstacles including the lack of specific targets, inhibition of tumor microenvironment (TME), homing barriers of CAR-T cells, differentiation and depletion of CAR-T cells, inhibition of immune checkpoints, trogocytosis of CAR-T cells, tumor antigen heterogeneity, etc. This paper reviews the obstacles influencing the efficacy of CAR-T cell immunotherapy in solid tumors, their mechanism, and coping strategies, as well as economic restriction of CAR-T cell immunotherapy and its solutions. It aims to provide some references for researchers to better overcome the obstacles that affect the efficacy of CAR-T cells in solid tumors.
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Affiliation(s)
- Lele Miao
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory of the Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
| | - Zhengchao Zhang
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory of the Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
| | - Zhijian Ren
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory of the Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
| | - Futian Tang
- Key Laboratory of the Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
| | - Yumin Li
- Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou, China.,Key Laboratory of the Digestive System Tumors of Gansu Province, Second Hospital of Lanzhou University, Lanzhou, China
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Jin X, Lu W, Zhang M, Xiong X, Sun R, Wei Y, He X, Zhao M. Infection Temperature Affects the Phenotype and Function of Chimeric Antigen Receptor T Cells Produced via Lentiviral Technology. Front Immunol 2021; 12:638907. [PMID: 33953713 PMCID: PMC8089475 DOI: 10.3389/fimmu.2021.638907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
Chimeric antigen receptor (CAR)-T cell therapy has become an important method for the treatment of hematological tumors. Lentiviruses are commonly used gene transfer vectors for preparing CAR-T cells, and the conditions for preparing CAR-T cells vary greatly. This study reported for the first time the influence of differences in infection temperature on the phenotype and function of produced CAR-T cells. Our results show that infection at 4 degrees produces the highest CAR-positive rate of T cells, infection at 37 degrees produces the fastest proliferation in CAR-T cells, and infection at 32 degrees produces CAR-T cells with the greatest proportion of naive cells and the lowest expression of immune checkpoints. Therefore, infection at 32 degrees is recommended to prepare CAR-T cells. CAR-T cells derived from infection at 32 degrees seem to have a balance between function and phenotype. Importantly, they have increased oncolytic ability. This research will help optimize the generation of CAR-T cells and improve the quality of CAR-T cell products.
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Affiliation(s)
- Xin Jin
- Nankai University School of Medicine, Tianjin, China
| | - Wenyi Lu
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
| | - Meng Zhang
- The First Central Clinical College of Tianjin Medical University, Tianjin, China
| | - Xia Xiong
- The First Central Clinical College of Tianjin Medical University, Tianjin, China
| | - Rui Sun
- Nankai University School of Medicine, Tianjin, China
| | - Yunxiong Wei
- The First Central Clinical College of Tianjin Medical University, Tianjin, China
| | - Xiaoyuan He
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
| | - Mingfeng Zhao
- Nankai University School of Medicine, Tianjin, China.,Department of Hematology, Tianjin First Central Hospital, Tianjin, China.,The First Central Clinical College of Tianjin Medical University, Tianjin, China
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46
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Sánchez‐Martínez D, Gutiérrez‐Agüera F, Romecin P, Vinyoles M, Palomo M, Tirado N, Zanetti SR, Juan M, Carlet M, Jeremias I, Menéndez P. Enforced sialyl-Lewis-X (sLeX) display in E-selectin ligands by exofucosylation is dispensable for CD19-CAR T-cell activity and bone marrow homing. Clin Transl Med 2021; 11:e280. [PMID: 33634970 PMCID: PMC7901721 DOI: 10.1002/ctm2.280] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 12/16/2022] Open
Abstract
CD19-directed chimeric antigen receptors (CAR) T cells induce impressive rates of complete response in advanced B-cell malignancies, specially in B-cell acute lymphoblastic leukemia (B-ALL). However, CAR T-cell-treated patients eventually progress due to poor CAR T-cell persistence and/or disease relapse. The bone marrow (BM) is the primary location for acute leukemia. The rapid/efficient colonization of the BM by systemically infused CD19-CAR T cells might enhance CAR T-cell activity and persistence, thus, offering clinical benefits. Circulating cells traffic to BM upon binding of tetrasaccharide sialyl-Lewis X (sLeX)-decorated E-selectin ligands (sialofucosylated) to the E-selectin receptor expressed in the vascular endothelium. sLeX-installation in E-selectin ligands is achieved through an ex vivo fucosylation reaction. Here, we sought to characterize the basal and cell-autonomous display of sLeX in CAR T-cells activated using different cytokines, and to assess whether exofucosylation of E-selectin ligands improves CD19-CAR T-cell activity and BM homing. We report that cell-autonomous sialofucosylation (sLeX display) steadily increases in culture- and in vivo-expanded CAR T cells, and that, the cytokines used during T-cell activation influence both the degree of such endogenous sialofucosylation and the CD19-CAR T-cell efficacy and persistence in vivo. However, glycoengineered enforced sialofucosylation of E-selectin ligands was dispensable for CD19-CAR T-cell activity and BM homing in multiple xenograft models regardless the cytokines employed for T-cell expansion, thus, representing a dispensable strategy for CD19-CAR T-cell therapy.
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Affiliation(s)
- Diego Sánchez‐Martínez
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Francisco Gutiérrez‐Agüera
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Paola Romecin
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Meritxell Vinyoles
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Marta Palomo
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Néstor Tirado
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Samanta Romina Zanetti
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of MedicineUniversity of BarcelonaBarcelonaSpain
| | - Manel Juan
- Servei d'ImmunologiaHospital Clínic de BarcelonaBarcelonaSpain
| | - Michela Carlet
- Department of Apoptosis in Hematopoietic Stem Cells, Helmholtz Center MunichGerman Center for Environmental Health (HMGU)MunichGermany
- Department of PediatricsDr von Hauner Children's Hospital, LMUMunichGermany
| | - Irmela Jeremias
- Department of Apoptosis in Hematopoietic Stem Cells, Helmholtz Center MunichGerman Center for Environmental Health (HMGU)MunichGermany
- Department of PediatricsDr von Hauner Children's Hospital, LMUMunichGermany
| | - Pablo Menéndez
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of MedicineUniversity of BarcelonaBarcelonaSpain
- Department of Biomedicine, School of MedicineUniversity of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red‐Oncología (CIBERONC)Instituto de Salud Carlos IIIMadridSpain
- Institució Catalana de Recerca i Estudis Avançats (ICREA)BarcelonaSpain
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Mukherjee S, Reddy O, Panch S, Stroncek D. Establishment of a cell processing laboratory to support hematopoietic stem cell transplantation and chimeric antigen receptor (CAR)-T cell therapy. Transfus Apher Sci 2021; 60:103066. [PMID: 33472742 DOI: 10.1016/j.transci.2021.103066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Cell processing laboratories are an important part of cancer treatment centers. Cell processing laboratories began by supporting hematopoietic stem cell (HSC) transplantation programs. These laboratories adapted closed bag systems, centrifuges, sterile connecting devices and other equipment used in transfusion services/blood banks to remove red blood cells and plasma from marrow and peripheral blood stem cells products. The success of cellular cancer immunotherapies such as Chimeric Antigen Receptor (CAR) T-cells has increased the importance of cell processing laboratories. Since many of the diseases successfully treated by CAR T-cell therapy are also treated by HSC transplantation and since HSC transplantation teams are well suited to manage patients treated with CAR T-cells, many cell processing laboratories have begun to produce CAR T-cells. The methods that have been used to process HSCs have been modified for T-cell enrichment, culture, stimulation, transduction and expansion for CAR T-cell production. While processing laboratories are well suited to manufacture CAR T-cells and other cellular therapies, producing these therapies is challenging. The manufacture of cellular therapies requires specialized facilities which are costly to build and maintain. The supplies and reagents, especially vectors, can also be expensive. Finally, highly skilled staff are required. The use of automated equipment for cell production may reduce labor requirements and the cost of facilities. The steps used to produce CAR T-cells are reviewed, as well as various strategies for establishing a laboratory to manufacture these cells.
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Affiliation(s)
- Somnath Mukherjee
- Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA; Department of Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India
| | - Opal Reddy
- Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA
| | - Sandhya Panch
- Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA
| | - David Stroncek
- Center for Cellular Engineering, Department of Transfusion Medicine, NIH Clinical Center, Bethesda, MD, USA.
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48
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Dai Z, Hu X, Jia X, Liu J, Yang Y, Niu P, Hu G, Tan T, Zhou J. Development and functional characterization of novel fully human anti-CD19 chimeric antigen receptors for T-cell therapy. J Cell Physiol 2021; 236:5832-5847. [PMID: 33432627 DOI: 10.1002/jcp.30267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/14/2020] [Accepted: 12/26/2020] [Indexed: 12/18/2022]
Abstract
Impressive outcomes have been achieved by chimeric antigen receptor (CAR)-T cell therapy using murine-derived single-chain variable fragment (scFv) FMC63 specific for CD19 in patients with B cell malignancies. However, evidence suggests that human anti-mouse immune responses might be responsible for poor persistence and dysfunction of CAR-T cells, leading to poor outcomes or early tumor recurrence. Substituting a fully human scFv for murine-derived scFv may address this clinically relevant concern. In this study, we discovered two human anti-CD19 scFv candidates through an optimized protein/cell alternative panning strategy and evaluated their function in CAR-T cells and CD19/CD3 bispecific antibody formats. The two clones exhibited excellent cytotoxicity in CAR-T cells and bispecific antibodies in vitro compared with the benchmarks FMC63 CAR-T cells and blinatumomab. Furthermore, Clone 78-BBz CAR-T cells exhibited similar in vivo antitumor activity to FMC63-BBz CAR-T cells. Our results indicate that Clone 78-BBz CAR has excellent efficacy and safety profile and is a good candidate for clinical development.
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Affiliation(s)
- Zhenyu Dai
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xuelian Hu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiangyin Jia
- Iaso Biotherapeutics Co. Ltd., Nanjing, Jiangsu, China
| | - Jianwei Liu
- Iaso Biotherapeutics Co. Ltd., Nanjing, Jiangsu, China
| | - Yongkun Yang
- Iaso Biotherapeutics Co. Ltd., Nanjing, Jiangsu, China
| | - Panpan Niu
- Iaso Biotherapeutics Co. Ltd., Nanjing, Jiangsu, China
| | - Guang Hu
- Iaso Biotherapeutics Co. Ltd., Nanjing, Jiangsu, China
| | - Taochao Tan
- Iaso Biotherapeutics Co. Ltd., Nanjing, Jiangsu, China
| | - Jianfeng Zhou
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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49
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Perez-Amill L, Suñe G, Antoñana-Vildosola A, Castella M, Najjar A, Bonet J, Fernández-Fuentes N, Inogés S, López A, Bueno C, Juan M, Urbano-Ispizua Á, Martín-Antonio B. Preclinical development of a humanized chimeric antigen receptor against B cell maturation antigen for multiple myeloma. Haematologica 2021; 106:173-184. [PMID: 31919085 PMCID: PMC7776337 DOI: 10.3324/haematol.2019.228577] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 01/03/2020] [Indexed: 11/09/2022] Open
Abstract
Multiple myeloma is a prevalent and incurable disease, despite the development of new and effective drugs. The recent development of chimeric antigen receptor (CAR)-T cell therapy has shown impressive results in the treatment of patients with relapsed or refractory hematological B cell malignancies. In the recent years, B-cell maturation antigen (BCMA) has appeared as a promising antigen to target using a variety of immuno-therapy treatments including CART cells, for MM patients. To this end, we generated clinical-grade murine CART cells directed against BCMA, named ARI2m cells. Having demonstrated its efficacy, and in an attempt to avoid the immune rejection of CART cells by the patient, the single chain variable fragment was humanized, creating ARI2h cells. ARI2h cells demonstrated comparable in vitro and in vivo efficacy to ARI2m cells, and superiority in cases of high tumor burden disease. In terms of inflammatory response, ARI2h cells showed a lower TNFα production and lower in vivo toxicity profile. Large-scale expansion of both ARI2m and ARI2h cells was efficiently conducted following Good Manufacturing Practice guidelines, obtaining the target CART cell dose required for treatment of multiple myeloma patients. Moreover, we demonstrate that soluble BCMA and BCMA released in vesicles impacts on CAR-BCMA activity. In summary, this study sets the bases for the implementation of a clinical trial (EudraCT code: 2019-001472-11) to study the efficacy of ARI2h cell treatment for multiple myeloma patients.
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Affiliation(s)
| | - Guillermo Suñe
- Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | | | - Maria Castella
- Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Amer Najjar
- Dept. of Pediatrics - Research, The University of Texas M. D. Anderson Cancer Center, Houston
| | - Jaume Bonet
- Lab. of Protein Design and Immunoengineering, Ecole Polytechnique Federale de Lausanne, Switzerland
| | | | - Susana Inogés
- Department of Immunology and Immunotherapy, Clinic Universitary of Navarra, Spain
| | - Ascensión López
- Department of Immunology and Immunotherapy, Clinic Universitary of Navarra, Spain
| | - Clara Bueno
- Josep Carreras Leukemia Research Institute/ Cell Therapy Program of the School of Medicine,Barcelona
| | - Manel Juan
- Department of Immunotherapy, Hospital Clinic, IDIBAPS, Barcelona
| | - Álvaro Urbano-Ispizua
- Hospital Clinic, IDIBAPS, Josep Carreras Leukaemia Research Institute, University of Barcelona
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50
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Pello OM, Lanzarot D, Colorado M, Amunarriz C, Insunza A, Álvarez‐Rodríguez L, Díez de Velasco M, Sainz‐Sainz N, Arroyo JL. Optimal large-scale CD34+ enrichment from a leukapheresis collection using the clinimacs prodigy platform. Clin Case Rep 2020; 8:2650-2653. [PMID: 33363798 PMCID: PMC7752486 DOI: 10.1002/ccr3.3232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 11/16/2022] Open
Abstract
Optimization of Hematology Patient's treatment: It is possible to obtain a 100% CD34+ recovery after CD34+ selection using the CliniMACS Prodigy.
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Affiliation(s)
- Oscar M. Pello
- Blood and Tissue Bank of CantabriaMarqués de Valdecilla FoundationSantanderSpain
- Haematologic Neoplasms and Haematopoietic Stem Cells Transplantation GroupMarqués de Valdecilla Research InstituteSantanderSpain
| | | | - Mercedes Colorado
- Haematologic Neoplasms and Haematopoietic Stem Cells Transplantation GroupMarqués de Valdecilla Research InstituteSantanderSpain
- Hematology DepartmentMarqués de Valdecilla HospitalSantanderSpain
| | - Cristina Amunarriz
- Blood and Tissue Bank of CantabriaMarqués de Valdecilla FoundationSantanderSpain
- Haematologic Neoplasms and Haematopoietic Stem Cells Transplantation GroupMarqués de Valdecilla Research InstituteSantanderSpain
| | - Andrés Insunza
- Haematologic Neoplasms and Haematopoietic Stem Cells Transplantation GroupMarqués de Valdecilla Research InstituteSantanderSpain
- Hematology DepartmentMarqués de Valdecilla HospitalSantanderSpain
| | - Lorena Álvarez‐Rodríguez
- Blood and Tissue Bank of CantabriaMarqués de Valdecilla FoundationSantanderSpain
- Haematologic Neoplasms and Haematopoietic Stem Cells Transplantation GroupMarqués de Valdecilla Research InstituteSantanderSpain
| | | | | | - José Luis Arroyo
- Blood and Tissue Bank of CantabriaMarqués de Valdecilla FoundationSantanderSpain
- Haematologic Neoplasms and Haematopoietic Stem Cells Transplantation GroupMarqués de Valdecilla Research InstituteSantanderSpain
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