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Sharma S, Sauer T, Omer BA, Shum T, Rollins LA, Rooney CM. Constitutive Interleukin-7 Cytokine Signaling Enhances the Persistence of Epstein-Barr Virus-Specific T-Cells. Int J Mol Sci 2023; 24:15806. [PMID: 37958791 PMCID: PMC10649234 DOI: 10.3390/ijms242115806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
The efficacy of therapeutic T-cells is limited by a lack of positive signals and excess inhibitory signaling in tumor microenvironments. We previously showed that a constitutively active IL7 receptor (C7R) enhanced the persistence, expansion, and anti-tumor activity of T-cells expressing chimeric antigen receptors (CARs), and C7R-modified GD2.CAR T-cells are currently undergoing clinical trials. To determine if the C7R could also enhance the activity of T-cells recognizing tumors via their native T-cell receptors (TCRs), we evaluated its effects in Epstein-Barr virus (EBV)-specific T-cells (EBVSTs) that have produced clinical benefits in patients with EBV-associated malignancies. EBVSTs were generated by stimulation of peripheral blood T-cells with overlapping peptide libraries spanning the EBV lymphoma antigens, LMP1, LMP2, and EBNA 1, followed by retroviral vector transduction to express the C7R. The C7R increased STAT5 signaling in EBVSTs and enhanced their expansion over 30 days of culture in the presence or absence of exogenous cytokines. C7R-EBVSTs maintained EBV antigen specificity but were dependent on TCR stimulation for continued expansion. C7R-EBVSTs produced more rapid lymphoma control in a murine xenograft model than unmodified EBVSTs and persisted for longer. The findings have led to a clinical trial, evaluating C7R-EBVSTs for the treatment of refractory or relapsed EBV-positive lymphoma (NCT04664179).
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Affiliation(s)
- Sandhya Sharma
- Graduate Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX 77030, USA; (S.S.)
- Center for Cell and Gene Therapy, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Tim Sauer
- Center for Cell and Gene Therapy, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Bilal A. Omer
- Center for Cell and Gene Therapy, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Thomas Shum
- Graduate Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX 77030, USA; (S.S.)
- Center for Cell and Gene Therapy, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lisa A. Rollins
- Center for Cell and Gene Therapy, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
| | - Cliona M. Rooney
- Center for Cell and Gene Therapy, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Pathology-Immunology, Baylor College of Medicine, Houston, TX 77030, USA
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Abstract
The lymphatic system plays an important role in balancing fluid compartments in the body. It is disrupted by various disease processes in the thorax, including injury to the thoracic lymphatic duct after surgery, as well as malignancy and heart failure. Because of the small size of lymphatic vessels, imaging of the lymphatics is relatively difficult, and effective imaging methods are still being optimized and developed. The standard of reference for lymphatic imaging has been conventional lymphangiography for several decades. Other modalities such as CT, noncontrast or contrast-enhanced MRI, and lymphoscintigraphy can also demonstrate lymphatic abnormalities and help in treatment planning. Imaging findings associated with lymphatic abnormalities can be seen in the pulmonary parenchyma, pleural space, and mediastinum. In the pulmonary parenchyma, common findings include interlobular septal thickening as well as reversal of lymphatic flow with intravasation of contrast material into pulmonary lymphatics. In the pleural space, findings include chylous pleural effusion and occasionally nonchylous pleural effusion. In the mediastinum, thoracic duct leak, plexiform thoracic duct, lymphatic malformations, and lymphangiectasis may occur. Management of chylothorax includes conservative or medical treatment, surgery, and interventional radiology procedures. The authors discuss thoracic lymphatic anatomy, imaging manifestations of lymphatic abnormalities in the various anatomic compartments, and interventional radiology treatment of chylothorax. Radiologists should be familiar with these imaging findings for diagnosis and to help guide appropriate management. ©RSNA, 2022.
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Affiliation(s)
- Jingshuo Derek Sun
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115
| | - Thomas Shum
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115
| | - Fardad Behzadi
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115
| | - Mark M Hammer
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115
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Omer B, Cardenas MG, Pfeiffer T, Daum R, Huynh M, Sharma S, Nouraee N, Xie C, Tat C, Perconti S, Van Pelt S, Scherer L, DeRenzo C, Shum T, Gottschalk S, Arber C, Rooney CM. A Costimulatory CAR Improves TCR-based Cancer Immunotherapy. Cancer Immunol Res 2022; 10:512-524. [PMID: 35176142 DOI: 10.1158/2326-6066.cir-21-0307] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/11/2021] [Accepted: 02/11/2022] [Indexed: 11/16/2022]
Abstract
T-cell receptors (TCR) recognize intracellular and extracellular cancer antigens, allowing T cells to target many tumor antigens. To sustain proliferation and persistence, T cells require not only signaling through the TCR (signal 1), but also costimulatory (signal 2) and cytokine (signal 3) signaling. Because most cancer cells lack costimulatory molecules, TCR engagement at the tumor site results in incomplete T-cell activation and transient antitumor effects. To overcome this lack of signal 2, we genetically modified tumor-specific T cells with a costimulatory chimeric antigen receptor (CoCAR). Like classical CARs, CoCARs combine the antigen-binding domain of an antibody with costimulatory endodomains to trigger T-cell proliferation, but CoCARs lack the cytotoxic CD3ζ chain to avoid toxicity to normal tissues. We first tested a CD19-targeting CoCAR in combination with an HLA-A*02:01-restricted, survivin-specific transgenic TCR (sTCR) in serial cocultures with leukemia cells coexpressing the cognate peptide-HLA complex (signal 1) and CD19 (signal 2). The CoCAR enabled sTCR+ T cells to kill tumors over a median of four additional tumor challenges. CoCAR activity depended on CD19 but was maintained in tumors with heterogeneous CD19 expression. In a murine tumor model, sTCR+CoCAR+ T cells improved tumor control and prolonged survival compared with sTCR+ T cells. We further evaluated the CoCAR in Epstein-Barr virus-specific T cells (EBVST). CoCAR-expressing EBVSTs expanded more rapidly than nontransduced EBVSTs and delayed tumor progression in an EBV+ murine lymphoma model. Overall, we demonstrated that the CoCAR can increase the activity of T cells expressing both native and transgenic TCRs and enhance antitumor responses.
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Affiliation(s)
- Bilal Omer
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Mara G Cardenas
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas
| | - Thomas Pfeiffer
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Rachel Daum
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas
| | - Mai Huynh
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas
| | - Sandhya Sharma
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas
| | - Nazila Nouraee
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas
| | - Cicilyn Xie
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas
| | - Candise Tat
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas
| | - Silvana Perconti
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas
| | - Stacey Van Pelt
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas
| | - Lauren Scherer
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Chris DeRenzo
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.,Department of Bone Marrow Transplant and Cellular Therapy, St. Jude's Children's Research Hospital, Memphis, Tennessee
| | - Thomas Shum
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Stephen Gottschalk
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.,Department of Bone Marrow Transplant and Cellular Therapy, St. Jude's Children's Research Hospital, Memphis, Tennessee
| | - Caroline Arber
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas.,Department of Oncology UNIL-CHUV, Lausanne University Hospital, University of Lausanne and Ludwig Institute for Cancer Research Lausanne, Epalinges, Switzerland
| | - Cliona M Rooney
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas
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Omer B, Shum T, Foster J, Parikh K, Tat C, Shekar M, Vivekananthan A, Mehta B, Zhang H, Thakkar SG, Naik S, Heslop HE, Brenner MK, Rooney CM. Phase I Trial of GD2.CAR T Cells Combined with a Novel Interleukin-7 Signal Modulator. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00290-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kruse RL, Huang Y, Shum T, Bai L, Ding H, Wang ZZ, Selaru FM, Kumbhari V. Endoscopic-mediated, biliary hydrodynamic injection mediating clinically relevant levels of gene delivery in pig liver. Gastrointest Endosc 2021; 94:1119-1130.e4. [PMID: 34197834 PMCID: PMC8605992 DOI: 10.1016/j.gie.2021.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/18/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Gene therapy could provide curative therapies to many inherited monogenic liver diseases. Clinical trials have largely focused on adeno-associated viruses (AAVs) for liver gene delivery. These vectors, however, are limited by small packaging size, capsid immune responses, and inability to redose. As an alternative, nonviral, hydrodynamic injection through vascular routes can successfully deliver plasmid DNA (pDNA) into mouse liver but has achieved limited success in large animal models. METHODS We explored hydrodynamic delivery of pDNA through the biliary system into the liver of pigs using ERCP and a power injector to supply hydrodynamic force. Human factor IX (hFIX), deficient in hemophilia B, was used as a model gene therapy. RESULTS Biliary hydrodynamic injection was well tolerated without significant changes in vital signs, liver enzymes, hematology, or histology. No off-target pDNA delivery to other organs was detected by polymerase chain reaction. Immunohistochemistry revealed that 50.19% of the liver stained positive for hFIX after hydrodynamic injection at 5.5 mg pDNA, with every hepatic lobule in all liver lobes demonstrating hFIX expression. hFIX-positive hepatocytes were concentrated around the central vein, radiating outward across all 3 metabolic zones. Biliary hydrodynamic injection in pigs resulted in significantly higher transfection efficiency than mouse vascular hydrodynamic injection at matched pDNA per liver weight dose (32.7%-51.9% vs 18.9%, P < .0001). CONCLUSIONS Biliary hydrodynamic injection using ERCP can achieve higher transfection efficiency into hepatocytes compared with AAVs at magnitudes of less cost in a clinically relevant human-sized large animal. This technology may serve as a platform for gene therapy of human liver diseases.
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Affiliation(s)
- Robert L Kruse
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yuting Huang
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, Maryland, USA
| | - Thomas Shum
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Lu Bai
- Department of Biology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hui Ding
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zack Z Wang
- Division of Hematology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Florin M Selaru
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vivek Kumbhari
- Division of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Division of Gastroenterology & Hepatology, Department of Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA
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Olbrich H, Theobald SJ, Slabik C, Gerasch L, Schneider A, Mach M, Shum T, Mamonkin M, Stripecke R. Adult and Cord Blood-Derived High-Affinity gB-CAR-T Cells Effectively React Against Human Cytomegalovirus Infections. Hum Gene Ther 2021; 31:423-439. [PMID: 32159399 PMCID: PMC7194322 DOI: 10.1089/hum.2019.149] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Human cytomegalovirus (HCMV) reactivations are associated with lower overall survival after transplantations. Adoptive transfer of HCMV-reactive expanded or selected T cells can be applied as a compassionate use, but requires that the human leukocyte antigen-matched donor provides memory cells against HCMV. To overcome this, we developed engineered T cells expressing chimeric antigen receptors (CARs) targeted against the HCMV glycoprotein B (gB) expressed upon viral reactivation. Single-chain variable fragments (scFvs) derived from a human high-affinity gB-specific neutralizing monoclonal antibody (SM5-1) were fused to CARs with 4-1BB (BBL) or CD28 (28S) costimulatory domains and subcloned into retroviral vectors. CD4+ and CD8+ T cells obtained from HCMV-seronegative adult blood or cord blood (CB) transduced with the vectors efficiently expressed the gB-CARs. The specificity and potency of gB-CAR-T cells were demonstrated and compared in vitro using the following: 293T cells expressing gB, and with mesenchymal stem cells infected with a HCMV TB40 strain expressing Gaussia luciferase (HCMV/GLuc). BBL-gB-CAR-T cells generated with adult or CB demonstrated significantly higher in vitro activation and cytotoxicity performance than 28-gB-CAR-T cells. Nod.Rag.Gamma (NRG) mice transplanted with human CB CD34+ cells with long-term human immune reconstitution were used to model HCMV/GLuc infection in vivo by optical imaging analyses. One week after administration, response to BBL-gB-CAR-T cell therapy was observed for 5/8 mice, defined by significant reduction of the bioluminescent signal in relation to untreated controls. Response to therapy was sporadically associated with CAR detection in spleen. Thus, exploring scFv derived from the high-affinity gB-antibody SM5-1 and the 4-1BB signaling domain for CAR design enabled an in vitro high on-target effect and cytotoxicity and encouraging results in vivo. Therefore, gB-CAR-T cells can be a future clinical option for treatment of HCMV reactivations, particularly when memory T cells from the donors are not available.
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Affiliation(s)
- Henning Olbrich
- Laboratory of Regenerative Immune Therapies Applied, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Sebastian J Theobald
- Laboratory of Regenerative Immune Therapies Applied, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Constanze Slabik
- Laboratory of Regenerative Immune Therapies Applied, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Laura Gerasch
- Laboratory of Regenerative Immune Therapies Applied, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Andreas Schneider
- Laboratory of Regenerative Immune Therapies Applied, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Michael Mach
- Institute for Clinical and Molecular Virology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas Shum
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas.,Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas
| | - Maksim Mamonkin
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
| | - Renata Stripecke
- Laboratory of Regenerative Immune Therapies Applied, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.,German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
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Chang A, Fong J, Yip W, Siu S, Soong I, Leung C, Shum T, Yeung E, Ngan R, Chan K, Wong J, Lee M, Chu Y. A Multi-Institutional Study Comparing Clinical Outcome and Toxicities of Novel Image-Guided Brachytherapy With Conventional Techniques for Locally Advanced Cervical Cancer in Hong Kong. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Longo J, PulivadulaVenkatasai J, Balasingh T, Ram T, Lee S, Chang A, Shum T, Erickson B, Frazer T. International Scholars in Radiation Oncology: A Single Institution Experience in Developing a Formal Program to Facilitate Capacity Building in Global Radiation Oncology. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Stephanie S, Shum T, Cleveland H, Challa SR, Herring A, Jacobson FL, Hatabu H, Byrne SC, Shashi K, Araki T, Hernandez JA, White CS, Hossain R, Hunsaker AR, Hammer MM. Determinants of Chest X-Ray Sensitivity for COVID- 19: A Multi-Institutional Study in the United States. Radiol Cardiothorac Imaging 2020; 2:e200337. [PMID: 33778628 PMCID: PMC7605075 DOI: 10.1148/ryct.2020200337] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose To evaluate the sensitivity, specificity, and severity of chest x-rays (CXR) and chest CTs over time in confirmed COVID-19+ and COVID-19- patients and to evaluate determinants of false negatives. Methods In a retrospective multi-institutional study, 254 RT-PCR verified COVID-19+ patients with at least one CXR or chest CT were compared with 254 age- and gender-matched COVID-19- controls. CXR severity, sensitivity, and specificity were determined with respect to time after onset of symptoms; sensitivity and specificity for chest CTs without time stratification. Performance of serial CXRs against CTs was determined by comparing area under the receiver operating characteristic curves (AUC). A multivariable logistic regression analysis was performed to assess factors related to false negative CXR. Results COVID-19+ CXR severity and sensitivity increased with time (from sensitivity of 55% at ≤2 days to 79% at >11 days; p<0.001 for trends of both severity and sensitivity) whereas CXR specificity decreased over time (from 83% to 70%, p=0.02). Serial CXR demonstrated increase in AUC (first CXR AUC=0.79, second CXR=0.87, p=0.02), and second CXR approached the accuracy of CT (AUC=0.92, p=0.11). COVID-19 sensitivity of first CXR, second CXR, and CT was 73%, 83%, and 88%, whereas specificity was 80%, 73%, and 77%, respectively. Normal and mild severity CXR findings were the largest factor behind false-negative CXRs (40% normal and 87% combined normal/mild). Young age and African-American ethnicity increased false negative rates. Conclusion CXR sensitivity in COVID-19 detection increases with time, and serial CXRs of COVID-19+ patients has accuracy approaching that of chest CT.
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Affiliation(s)
- Stephanie Stephanie
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Thomas Shum
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Heather Cleveland
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Suryanarayana R Challa
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Allison Herring
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Francine L Jacobson
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Hiroto Hatabu
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Suzanne C Byrne
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Kumar Shashi
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Tetsuro Araki
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Jose A Hernandez
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Charles S White
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Rydhwana Hossain
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Andetta R Hunsaker
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
| | - Mark M Hammer
- Department of Internal Medicine, University of Maryland School of Medicine, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201 (S.S., T.S., S.R.C.); Department of Physician Assistant Studies, Massachusetts General Hospital Institute of Health Professions, 55 Fruit St, Boston, MA 02114 (H.C.); Department of Radiology, University of Maryland School of Medicine, Downtown Campus, 22 S Greene St, Baltimore, MD 21201 (A.H., C.S.W., R.H.); Department of Pediatric Radiology, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030 (J.A.H.); and Department of Radiology, The Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02114 (F.L.J., H.H., S.C.B., K.S., T.A., A.R.H., M.M.H.)
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10
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Sharma S, Shum T, Parikh K, Omer B, Rooney C. Modulating Interlukin-7 (IL-7) cytokine receptor signaling to enhance the persistence and anti-tumor efficacy of Epstein-Barr Virus (EBV) specific T-cells in EBV positive malignancies. The Journal of Immunology 2019. [DOI: 10.4049/jimmunol.202.supp.71.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
EBV-specific T-cells (EBVSTs) targeting viral proteins in EBV+ lymphoma patients have produced 50% clinical response. Limited T-cell expansion and persistence attributed to lack of cytokines in the tumor microenvironment (TME) remains a major challenge. IL-7 signaling has survival and anti-apoptotic effects on T-cells, however, IL-7 availability in vivo is limited and the IL7 receptor is downregulated on activated T-cells. We aim to overcome this limitation of suppressive TME by augmenting IL-7 signaling.
We recently reported the transgenic expression of a constitutively active IL-7 receptor (C7R) to provide the proliferative and survival advantage in T-cells. Hence, we hypothesize that EBVSTs endowed with cytokine-independent C7R signaling will have resistance to the immunosuppressive TME and increased persistence and anti-tumor potency.
C7R expressing EBVSTs demonstrated enhanced antigen-specific IFN-γ release and superior target specific cytotoxicity in-vitro. In contrast to unmodified EBVSTs, C7R-EBVSTs demonstrated EBV antigen dependent, cytokine-independent proliferation and survival, associated with increased phosphorylated STAT5. Furthermore, C7R signaling provided resistance against TGFβ, Arginase-I, and M2 macrophages, as demonstrated by increased proliferation attributed to decreased apoptosis in C7R-EBVSTs. Following adoptive transfer in an EBV+ murine xenograft model, C7R-EBVSTs persisted significantly longer and demonstrated tumor clearance, while unmodified EBVSTs failed.
C7R signaling augments EBVSTs potency and persistence against suppressive components of TME in our preclinical models. Once effective, the findings will be translated to clinical trials in EBV+ malignancies.
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Affiliation(s)
| | | | | | - Bilal Omer
- 1Baylor College of Medicine
- 2Houston Methodist Research Institute
| | - Cliona Rooney
- 1Baylor College of Medicine
- 2Houston Methodist Research Institute
- 3Texas Children’s Hosp
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11
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Omer B, Castillo PA, Tashiro H, Shum T, Huynh MTA, Cardenas M, Tanaka M, Lewis A, Sauer T, Parihar R, Lapteva N, Schmueck-Henneresse M, Mukherjee M, Gottschalk S, Rooney CM. Chimeric Antigen Receptor Signaling Domains Differentially Regulate Proliferation and Native T Cell Receptor Function in Virus-Specific T Cells. Front Med (Lausanne) 2018; 5:343. [PMID: 30619856 PMCID: PMC6297364 DOI: 10.3389/fmed.2018.00343] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/22/2018] [Indexed: 11/16/2022] Open
Abstract
The efficacy of T cells expressing chimeric antigen receptors (CARs) for solid tumors has been limited by insufficient CAR T cell expansion and persistence. The use of virus-specific T cells (VSTs) as carriers for CARs may overcome this limitation since CAR-VSTs can be boosted by viral vaccines or oncolytic viruses. However, there is limited understanding of the optimal combination of endodomains and their influence on the native T cell receptor (TCR) in VSTs. We therefore compared the function of GD2.CARs expressing the TCR zeta chain (ζ) alone or combined with endodomains from CD28 and 4-1BB in varicella zoster virus-specific (VZV) T cells. VZVSTs expressing GD2-CARs recognized VZV-derived peptides and killed GD2-expressing tumor cells. However, after repeated stimulation through their native TCR, the expansion of GD2-CAR.CD28ζ-VZVSTs was 3.3-fold greater (p < 0.001) than non-transduced VZVSTs, whereas GD2-CARζ- and GD2-CAR.41BBζ inhibited VZVST expansion (p < 0.01). Compared to control VZVSTs, GD2-CAR.ζ VZVSTs showed a greater frequency of apoptotic (p < 0.01) T cells, whereas prolonged downregulation of the native αβ TCR was observed in GD2-CAR.41BBζ VZVSTs (p < 0.001). We confirmed that CD28ζ can best maintain TCR function by expressing GD2.CARs in Epstein-Barr virus-specific T cells and CD19-CARs in VZVSTs. In response to CAR stimulation VSTs with CD28ζ endodomains also showed the greatest expansion (6 fold > GD2-CAR.41BBζ VZVSTs (p < 0.001), however anti-tumor efficacy was superior in GD2-CAR.41BBζ-VZVSTs. These findings demonstrate that CAR signaling domains can enhance or diminish the function of the native TCR and indicate that only CD28ζ may preserve the function of the native TCR in tonically signaling CAR-VSTs.
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Affiliation(s)
- Bilal Omer
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Paul A Castillo
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Haruko Tashiro
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Thomas Shum
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Mai T A Huynh
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Mara Cardenas
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Miyuki Tanaka
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Andrew Lewis
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Tim Sauer
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Robin Parihar
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Natalia Lapteva
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Michael Schmueck-Henneresse
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Malini Mukherjee
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States
| | - Stephen Gottschalk
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United States
| | - Cliona M Rooney
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Texas Children's Hospital, Houston, TX, United States.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United States.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States
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12
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Samaha H, Pignata A, Fousek K, Ren J, Lam FW, Stossi F, Dubrulle J, Salsman VS, Krishnan S, Hong SH, Baker ML, Shree A, Gad AZ, Shum T, Fukumura D, Byrd TT, Mukherjee M, Marrelli SP, Orange JS, Joseph SK, Sorensen PH, Taylor MD, Hegde M, Mamonkin M, Jain RK, El-Naggar S, Ahmed N. A homing system targets therapeutic T cells to brain cancer. Nature 2018; 561:331-337. [PMID: 30185905 PMCID: PMC6402337 DOI: 10.1038/s41586-018-0499-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 08/08/2018] [Indexed: 12/14/2022]
Abstract
Successful T cell immunotherapy for brain cancer requires that the T cells can access tumour tissues, but this has been difficult to achieve. Here we show that, in contrast to inflammatory brain diseases such as multiple sclerosis, where endothelial cells upregulate ICAM1 and VCAM1 to guide the extravasation of pro-inflammatory cells, cancer endothelium downregulates these molecules to evade immune recognition. By contrast, we found that cancer endothelium upregulates activated leukocyte cell adhesion molecule (ALCAM), which allowed us to overcome this immune-evasion mechanism by creating an ALCAM-restricted homing system (HS). We re-engineered the natural ligand of ALCAM, CD6, in a manner that triggers initial anchorage of T cells to ALCAM and conditionally mediates a secondary wave of adhesion by sensitizing T cells to low-level ICAM1 on the cancer endothelium, thereby creating the adhesion forces necessary to capture T cells from the bloodstream. Cytotoxic HS T cells robustly infiltrated brain cancers after intravenous injection and exhibited potent antitumour activity. We have therefore developed a molecule that targets the delivery of T cells to brain cancer.
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Affiliation(s)
- Heba Samaha
- Children's Cancer Hospital Egypt-57357, Cairo, Egypt
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Antonella Pignata
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Kristen Fousek
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
- Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jun Ren
- Edwin L. Steele Laboratories for Tumor Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Fong W Lam
- Baylor College of Medicine, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Center for Translational Research on Inflammatory Diseases at the Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Fabio Stossi
- Baylor College of Medicine, Houston, TX, USA
- Integrated Microscopy Core, Advanced Technology Cores, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Julien Dubrulle
- Baylor College of Medicine, Houston, TX, USA
- Integrated Microscopy Core, Advanced Technology Cores, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Vita S Salsman
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Shanmugarajan Krishnan
- Edwin L. Steele Laboratories for Tumor Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sung-Ha Hong
- Department of Neurology, McGovern Medical School at UT Health, Houston, TX, USA
| | - Matthew L Baker
- Baylor College of Medicine, Houston, TX, USA
- National Center for Macromolecular Imaging, Baylor College of Medicine, Houston, TX, USA
| | - Ankita Shree
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Ahmed Z Gad
- Children's Cancer Hospital Egypt-57357, Cairo, Egypt
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
- Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Thomas Shum
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
- Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Dai Fukumura
- Edwin L. Steele Laboratories for Tumor Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tiara T Byrd
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
- Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Malini Mukherjee
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
- Center for Human Immunobiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Sean P Marrelli
- Department of Neurology, McGovern Medical School at UT Health, Houston, TX, USA
| | - Jordan S Orange
- Baylor College of Medicine, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Center for Human Immunobiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Sujith K Joseph
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Poul H Sorensen
- Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael D Taylor
- Developmental and Stem Cell Biology Program, The Arthur and Sonia Labatt Brain Tumour Research Centre, Division of Neurosurgery, Departments of Surgery, Laboratory Medicine and Pathobiology, and of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Meenakshi Hegde
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
- Houston Methodist Hospital, Houston, TX, USA
- Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Maksim Mamonkin
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA
- Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
- Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Rakesh K Jain
- Edwin L. Steele Laboratories for Tumor Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Nabil Ahmed
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX, USA.
- Texas Children's Hospital, Houston, TX, USA.
- Baylor College of Medicine, Houston, TX, USA.
- Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX, USA.
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
- Houston Methodist Hospital, Houston, TX, USA.
- Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA.
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13
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Shum T, Kruse RL, Rooney CM. Strategies for enhancing adoptive T-cell immunotherapy against solid tumors using engineered cytokine signaling and other modalities. Expert Opin Biol Ther 2018; 18:653-664. [PMID: 29727246 DOI: 10.1080/14712598.2018.1473368] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Cancer therapy has been transformed by the demonstration that tumor-specific T-cells can eliminate tumor cells in a clinical setting with minimal long-term toxicity. However, significant success in the treatment of leukemia and lymphoma with T-cells using native receptors or redirected with chimeric antigen receptors (CARs) has not been recapitulated in the treatment of solid tumors. This lack of success is likely related to the paucity of costimulatory and cytokine signaling available in solid tumors, in addition to a range of inhibitory mechanisms. AREAS COVERED We summarize the latest developments in engineered T-cell immunotherapy, describe the limitations of these approaches in treating solid tumors, and finally highlight several strategies that may be useful in mediating solid tumor responses in the future, while also ensuring safety of engineered cells. EXPERT OPINION CAR-T therapies require further engineering to achieve their potential against solid tumors. Facilitating cytokine signaling in CAR T-cells appears to be essential in achieving better responses. However, the engineering of T-cells with potentially unchecked proliferation and potency raises the question of whether the simultaneous combination of enhancements will prove safe, necessitating continued advancements in regulating CAR-T activity at the tumor site and methods to safely switch off these engineered cells.
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Affiliation(s)
- Thomas Shum
- a Center for Cell and Gene Therapy, Texas Children's Hospital , Houston Methodist Hospital, and Baylor College of Medicine , Houston , Texas , USA.,b Medical Scientist Training Program , Baylor College of Medicine , Houston , Texas , USA.,c Interdepartmental Program in Translational Biology and Molecular Medicine , Baylor College of Medicine , Houston , Texas , USA
| | - Robert L Kruse
- a Center for Cell and Gene Therapy, Texas Children's Hospital , Houston Methodist Hospital, and Baylor College of Medicine , Houston , Texas , USA.,b Medical Scientist Training Program , Baylor College of Medicine , Houston , Texas , USA.,c Interdepartmental Program in Translational Biology and Molecular Medicine , Baylor College of Medicine , Houston , Texas , USA
| | - Cliona M Rooney
- a Center for Cell and Gene Therapy, Texas Children's Hospital , Houston Methodist Hospital, and Baylor College of Medicine , Houston , Texas , USA.,c Interdepartmental Program in Translational Biology and Molecular Medicine , Baylor College of Medicine , Houston , Texas , USA.,d Department of Pediatrics , Baylor College of Medicine , Houston , Texas , USA.,e Texas Children's Cancer and Hematology Centers , Baylor College of Medicine , Houston , Texas , USA.,f Department of Pathology and Immunology , Baylor College of Medicine , Houston , Texas , USA.,g Department of Molecular Virology and Microbiology , Baylor College of Medicine , Houston , Texas , USA
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14
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Kruse RL, Shum T, Tashiro H, Barzi M, Yi Z, Whitten-Bauer C, Legras X, Bissig-Choisat B, Garaigorta U, Gottschalk S, Bissig KD. HBsAg-redirected T cells exhibit antiviral activity in HBV-infected human liver chimeric mice. Cytotherapy 2018; 20:697-705. [PMID: 29631939 DOI: 10.1016/j.jcyt.2018.02.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/02/2018] [Accepted: 02/04/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Chronic hepatitis B virus (HBV) infection remains incurable. Although HBsAg-specific chimeric antigen receptor (HBsAg-CAR) T cells have been generated, they have not been tested in animal models with authentic HBV infection. METHODS We generated a novel CAR targeting HBsAg and evaluated its ability to recognize HBV+ cell lines and HBsAg particles in vitro. In vivo, we tested whether human HBsAg-CAR T cells would have efficacy against HBV-infected hepatocytes in human liver chimeric mice. RESULTS HBsAg-CAR T cells recognized HBV-positive cell lines and HBsAg particles in vitro as judged by cytokine production. However, HBsAg-CAR T cells did not kill HBV-positive cell lines in cytotoxicity assays. Adoptive transfer of HBsAg-CAR T cells into HBV-infected humanized mice resulted in accumulation within the liver and a significant decrease in plasma HBsAg and HBV-DNA levels compared with control mice. Notably, the fraction of HBV core-positive hepatocytes among total human hepatocytes was greatly reduced after HBsAg-CAR T cell treatment, pointing to noncytopathic viral clearance. In agreement, changes in surrogate human plasma albumin levels were not significantly different between treatment and control groups. CONCLUSIONS HBsAg-CAR T cells have anti-HBV activity in an authentic preclinical HBV infection model. Our results warrant further preclinical exploration of HBsAg-CAR T cells as immunotherapy for HBV.
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Affiliation(s)
- Robert L Kruse
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas, USA; Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, Texas, USA; Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, Texas, USA; Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, USA
| | - Thomas Shum
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas, USA; Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, Texas, USA; Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, USA
| | - Haruko Tashiro
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Mercedes Barzi
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas, USA; Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Zhongzhen Yi
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas, USA
| | | | - Xavier Legras
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas, USA; Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Beatrice Bissig-Choisat
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas, USA; Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, Texas, USA; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
| | | | - Stephen Gottschalk
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas, USA; Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, Texas, USA; Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA; Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA; Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas, USA
| | - Karl-Dimiter Bissig
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, Baylor College of Medicine, Houston, Texas, USA; Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, Texas, USA; Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, Texas, USA; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA.
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15
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Kruse RL, Shum T, Legras X, Barzi M, Pankowicz FP, Gottschalk S, Bissig KD. In Situ Liver Expression of HBsAg/CD3-Bispecific Antibodies for HBV Immunotherapy. Mol Ther Methods Clin Dev 2017; 7:32-41. [PMID: 29018834 PMCID: PMC5626922 DOI: 10.1016/j.omtm.2017.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 08/24/2017] [Indexed: 02/07/2023]
Abstract
Current therapies against hepatitis B virus (HBV) do not reliably cure chronic infection, necessitating new therapeutic approaches. The T cell response can clear HBV during acute infection, and the adoptive transfer of antiviral T cells during bone marrow transplantation can cure patients of chronic HBV infection. To redirect T cells to HBV-infected hepatocytes, we delivered plasmids encoding bispecific antibodies directed against the viral surface antigen (HBsAg) and CD3, expressed on almost all T cells, directly into the liver using hydrodynamic tail vein injection. We found a significant reduction in HBV-driven reporter gene expression (184-fold) in a mouse model of acute infection, which was 30-fold lower than an antibody only recognizing HBsAg. While bispecific antibodies triggered, in part, antigen-independent T cell activation, antibody production within hepatocytes was non-cytotoxic. We next tested the bispecific antibodies in a different HBV mouse model, which closely mimics the transcriptional template for HBV, covalently closed circular DNA (cccDNA). We found that the antiviral effect was noncytopathic, mediating a 495-fold reduction in HBsAg levels at day 4. At day 33, bispecific antibody-treated mice exhibited 35-fold higher host HBsAg immunoglobulin G (IgG) antibody production versus untreated groups. Thus, gene therapy with HBsAg/CD3-bispecific antibodies represents a promising therapeutic strategy for patients with HBV.
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Affiliation(s)
- Robert L Kruse
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, TX 77030, USA.,Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, TX 77030, USA.,Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030, USA
| | - Thomas Shum
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, TX 77030, USA.,Medical Scientist Training Program, Baylor College of Medicine, Houston, TX 77030, USA
| | - Xavier Legras
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Mercedes Barzi
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Frank P Pankowicz
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Stephen Gottschalk
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, TX 77030, USA.,Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030, USA.,Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Karl-Dimiter Bissig
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030, USA.,Center for Stem Cells and Regenerative Medicine, Baylor College of Medicine, Houston, TX 77030, USA.,Translational Biology and Molecular Medicine Program, Baylor College of Medicine, Houston, TX 77030, USA.,Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX 77030, USA
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16
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Shum T, Omer B, Tashiro H, Kruse RL, Wagner DL, Parikh K, Yi Z, Sauer T, Liu D, Parihar R, Castillo P, Liu H, Brenner MK, Metelitsa LS, Gottschalk S, Rooney CM. Constitutive Signaling from an Engineered IL7 Receptor Promotes Durable Tumor Elimination by Tumor-Redirected T Cells. Cancer Discov 2017; 7:1238-1247. [PMID: 28830878 DOI: 10.1158/2159-8290.cd-17-0538] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/19/2017] [Accepted: 08/15/2017] [Indexed: 01/05/2023]
Abstract
Successful adoptive T-cell immunotherapy of solid tumors will require improved expansion and cytotoxicity of tumor-directed T cells within tumors. Providing recombinant or transgenic cytokines may produce the desired benefits but is associated with significant toxicities, constraining clinical use. To circumvent this limitation, we constructed a constitutively signaling cytokine receptor, C7R, which potently triggers the IL7 signaling axis but is unresponsive to extracellular cytokine. This strategy augments modified T-cell function following antigen exposure, but avoids stimulating bystander lymphocytes. Coexpressing the C7R with a tumor-directed chimeric antigen receptor (CAR) increased T-cell proliferation, survival, and antitumor activity during repeated exposure to tumor cells, without T-cell dysfunction or autonomous T-cell growth. Furthermore, C7R-coexpressing CAR T cells were active against metastatic neuroblastoma and orthotopic glioblastoma xenograft models even at cell doses that had been ineffective without C7R support. C7R may thus be able to enhance antigen-specific T-cell therapies against cancer.Significance: The constitutively signaling C7R system developed here delivers potent IL7 stimulation to CAR T cells, increasing their persistence and antitumor activity against multiple preclinical tumor models, supporting its clinical development. Cancer Discov; 7(11); 1238-47. ©2017 AACR.This article is highlighted in the In This Issue feature, p. 1201.
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Affiliation(s)
- Thomas Shum
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas.,Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas.,Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas
| | - Bilal Omer
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, Texas
| | - Haruko Tashiro
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas
| | - Robert L Kruse
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas.,Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas.,Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas
| | - Dimitrios L Wagner
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas
| | - Kathan Parikh
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas
| | - Zhongzhen Yi
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas
| | - Tim Sauer
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas
| | - Daofeng Liu
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas
| | - Robin Parihar
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas
| | - Paul Castillo
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas
| | - Hao Liu
- Biostatistics Shared Resource, Baylor College of Medicine, Houston, Texas
| | - Malcolm K Brenner
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Leonid S Metelitsa
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Stephen Gottschalk
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Cliona M Rooney
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital, and Baylor College of Medicine, Houston, Texas. .,Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
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17
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Tashiro H, Sauer T, Shum T, Parikh K, Mamonkin M, Omer B, Rouce RH, Lulla P, Rooney CM, Gottschalk S, Brenner MK. Treatment of Acute Myeloid Leukemia with T Cells Expressing Chimeric Antigen Receptors Directed to C-type Lectin-like Molecule 1. Mol Ther 2017; 25:2202-2213. [PMID: 28676343 DOI: 10.1016/j.ymthe.2017.05.024] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/28/2017] [Accepted: 05/31/2017] [Indexed: 01/05/2023] Open
Abstract
The successful immunotherapy of acute myeloid leukemia (AML) has been hampered because most potential antigenic targets are shared with normal hematopoietic stem cells (HSCs), increasing the risk of sustained and severe hematopoietic toxicity following treatment. C-type lectin-like molecule 1 (CLL-1) is a membrane glycoprotein expressed by >80% of AML but is absent on normal HSCs. Here we describe the development and evaluation of CLL-1-specific chimeric antigen receptor T cells (CLL-1.CAR-Ts) and we demonstrate their specific activity against CLL-1+ AML cell lines as well as primary AML patient samples in vitro. CLL-1.CAR-Ts selectively reduced leukemic colony formation in primary AML patient peripheral blood mononuclear cells compared to control T cells. In a human xenograft mouse model, CLL-1.CAR-Ts mediated anti-leukemic activity against disseminated AML and significantly extended survival. By contrast, the colony formation of normal progenitor cells remained intact following CLL-1.CAR-T treatment. Although CLL-1.CAR-Ts are cytotoxic to mature normal myeloid cells, the selective sparing of normal hematopoietic progenitor cells should allow full myeloid recovery once CLL-1.CAR-T activity terminates. To enable elective ablation of the CAR-T, we therefore introduced the inducible caspase-9 suicide gene system and we show that exposure to the activating drug rapidly induced a controlled decrease of unwanted CLL-1.CAR-T activity against mature normal myeloid cells.
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Affiliation(s)
- Haruko Tashiro
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA.
| | - Tim Sauer
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA; Department of Internal Medicine A, Hematology and Oncology, University of Muenster, 48149 Muenster, Germany
| | - Thomas Shum
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA; Interdepartmental Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Kathan Parikh
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA
| | - Maksim Mamonkin
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA; Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Bilal Omer
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX 77030, USA
| | - Rayne H Rouce
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX 77030, USA
| | - Premal Lulla
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA; Section of Hematology/Oncology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Cliona M Rooney
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA; Department of Molecular Virology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Stephen Gottschalk
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Malcolm K Brenner
- Center for Cell and Gene Therapy, Texas Children's Hospital, Houston Methodist Hospital and Baylor College of Medicine, Houston, TX 77030, USA
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18
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Schmueck-Henneresse M, Omer B, Shum T, Tashiro H, Mamonkin M, Lapteva N, Sharma S, Rollins L, Dotti G, Reinke P, Volk HD, Rooney CM. Comprehensive Approach for Identifying the T Cell Subset Origin of CD3 and CD28 Antibody-Activated Chimeric Antigen Receptor-Modified T Cells. J Immunol 2017; 199:348-362. [PMID: 28550199 DOI: 10.4049/jimmunol.1601494] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 05/03/2017] [Indexed: 12/27/2022]
Abstract
The outcome of therapy with chimeric Ag receptor (CAR)-modified T cells is strongly influenced by the subset origin of the infused T cells. However, because polyclonally activated T cells acquire a largely CD45RO+CCR7- effector memory phenotype after expansion, regardless of subset origin, it is impossible to know which subsets contribute to the final T cell product. To determine the contribution of naive T cell, memory stem T cell, central memory T cell, effector memory T cell, and terminally differentiated effector T cell populations to the CD3 and CD28-activated CAR-modified T cells that we use for therapy, we followed the fate and function of individually sorted CAR-modified T cell subsets after activation with CD3 and CD28 Abs (CD3/28), transduction and culture alone, or after reconstitution into the relevant subset-depleted population. We show that all subsets are sensitive to CAR transduction, and each developed a distinct T cell functional profile during culture. Naive-derived T cells showed the greatest rate of proliferation but had more limited effector functions and reduced killing compared with memory-derived populations. When cultured in the presence of memory T cells, naive-derived T cells show increased differentiation, reduced effector cytokine production, and a reduced reproliferative response to CAR stimulation. CD3/28-activated T cells expanded in IL-7 and IL-15 produced greater expansion of memory stem T cells and central memory T cell-derived T cells compared with IL-2. Our strategy provides a powerful tool to elucidate the characteristics of CAR-modified T cells, regardless of the protocol used for expansion, reveals the functional properties of each expanded T cell subset, and paves the way for a more detailed evaluation of the effects of manufacturing changes on the subset contribution to in vitro-expanded T cells.
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Affiliation(s)
- Michael Schmueck-Henneresse
- Institute for Medical Immunology, Charité University Medicine Berlin, D-13353 Berlin, Germany; .,Renal and Transplant Research Unit, Department of Nephrology and Internal Intensive Care, Charité University Medicine Berlin, D-13353 Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité University Medicine Berlin, D-13353 Berlin, Germany.,Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030
| | - Bilal Omer
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030.,Houston Methodist Hospital, Houston, TX 77030.,Texas Children's Hospital, Houston, TX 77030.,Division of Hematology and Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030
| | - Thomas Shum
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030.,Houston Methodist Hospital, Houston, TX 77030.,Texas Children's Hospital, Houston, TX 77030.,Graduate Program of Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX 77030
| | - Haruko Tashiro
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030.,Houston Methodist Hospital, Houston, TX 77030.,Texas Children's Hospital, Houston, TX 77030
| | - Maksim Mamonkin
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030.,Houston Methodist Hospital, Houston, TX 77030.,Texas Children's Hospital, Houston, TX 77030
| | - Natalia Lapteva
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030.,Houston Methodist Hospital, Houston, TX 77030.,Texas Children's Hospital, Houston, TX 77030
| | - Sandhya Sharma
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030.,Houston Methodist Hospital, Houston, TX 77030.,Texas Children's Hospital, Houston, TX 77030.,Graduate Program of Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, TX 77030
| | - Lisa Rollins
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030.,Houston Methodist Hospital, Houston, TX 77030.,Texas Children's Hospital, Houston, TX 77030
| | - Gianpietro Dotti
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030.,Houston Methodist Hospital, Houston, TX 77030.,Texas Children's Hospital, Houston, TX 77030
| | - Petra Reinke
- Renal and Transplant Research Unit, Department of Nephrology and Internal Intensive Care, Charité University Medicine Berlin, D-13353 Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité University Medicine Berlin, D-13353 Berlin, Germany
| | - Hans-Dieter Volk
- Institute for Medical Immunology, Charité University Medicine Berlin, D-13353 Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies, Charité University Medicine Berlin, D-13353 Berlin, Germany
| | - Cliona M Rooney
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030.,Houston Methodist Hospital, Houston, TX 77030.,Texas Children's Hospital, Houston, TX 77030.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX 77030; and.,Department of Pathology, Baylor College of Medicine, Houston, TX 77030
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19
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Samaha H, Pignata A, Fousek K, Byrd T, Lam F, Stossi F, Marelli S, Shum T, Joseph S, Hegde M, Ahmed NM. A cellular platform to enable targeted brain delivery of T cells to glioblastoma. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.2053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2053 Background: Poor T cell homing hinders the development of effective cell therapy for central nervous system (CNS) malignancies. Lessons learnt from inflammatory brain diseases can give insight into how to overcome the blood brain barrier (BBB) blockade created by cancer. Activated Leukocyte Cell Adhesion Molecule (ALCAM; CD166) is a pathological adhesion molecule upregulated in the endothelium of a number of inflammatory/infiltrative CNS diseases, such as multiple sclerosis. Antibodies blocking ALCAM decrease leukocyte access to the brain and are currently being tested in a clinical trial for MS. Methods: We studied the difference in the dynamic signature of adhesion molecules in the “anergic” brain tumor endothelium and that of infiltrative brain conditions. Consequently, we mapped the ALCAM minimal binding region to domain 3 (D3) of CD6 and created an artificial molecule with the intent of creating a novel cellular platform to reverse endothelial anergy, through ALCAM specific binding. Results: GBM endothelium fails to launch the second wave of adhesion molecules necessary for firm T leukocyte capture and effective BBB transmigration. Engineered D3 on the T cell crosslinked to ALCAM on endothelial cells in proximity ligation assays (PLA; < 40nm) during TEM. Under shear stress, D3 T cells showed a global improved ALCAM specific trafficking kinetics: higher capture on ALCAM+ endothelium, rolling with slower velocity, and better TEM. In an ex vivo model of BBB, D3 T cells exhibited higher transmigratory ability. We discovered that signaling through the D3 endodomain phosphorylated pZAp70 recruiting Talin that enables LFA-1 (ICAM-ligand) open confirmation, mediating effective TEM. Lastly, in an orthotopic model of GBM, D3 T cells homed more and accumulated at the tumor site compared to NT controls. And, testing Her2 CAR T cells on D3 platform showed an advantageous homing after IV administration which was reflected in tumor control and better survival. Conclusions: We created a cellular platform that enables targeted brain delivery of T cells. This platform serves as a gateway to the effective cellular therapeutics for brain malignancies but potentially as a delivery system for complex biologics for other pathological conditions.
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Affiliation(s)
| | | | | | | | - Fong Lam
- Baylor College of Medicine, Houston, TX
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20
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Samaha H, Pignata A, Fousek K, Byrd T, Marelli S, Stossi F, Shum T, Lam F, Hedge M, Ahmed N. A cellular platform enables targeted brain delivery of T cells. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Yau T, Shum T, Lee A, Yeung M, Ng W, Chan L. A phase II study of pemetrexed combined with cisplatin in patients with recurrent or metastatic nanopharyngeal carcinoma. Oral Oncol 2012; 48:441-4. [DOI: 10.1016/j.oraloncology.2011.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 12/05/2011] [Accepted: 12/06/2011] [Indexed: 12/13/2022]
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