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Bouquet L, Bôle-Richard E, Warda W, Neto Da Rocha M, Trad R, Nicod C, Haderbache R, Genin D, Ferrand C, Deschamps M. RapaCaspase-9-based suicide gene applied to the safety of IL-1RAP CAR-T cells. Gene Ther 2023; 30:706-713. [PMID: 37173386 PMCID: PMC10506905 DOI: 10.1038/s41434-023-00404-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 11/07/2022] [Revised: 03/30/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
Even if adoptive cell transfer (ACT) has already shown great clinical efficiency in different types of disease, such as cancer, some adverse events consistently occur, and suicide genes are an interesting system to manage these events. Our team developed a new medical drug candidate, a chimeric antigen receptor (CAR) targeting interleukin-1 receptor accessory protein (IL-1RAP), which needs to be evaluated in clinical trials with a clinically applicable suicide gene system. To prevent side effects and ensure the safety of our candidate, we devised two constructs carrying an inducible suicide gene, RapaCasp9-G or RapaCasp9-A, containing a single-nucleotide polymorphism (rs1052576) affecting the efficiency of endogenous caspase 9. These suicide genes are activated by rapamycin and based on the fusion of human caspase 9 with a modified human FK-binding protein, allowing conditional dimerization. RapaCasp9-G- and RapaCasp9-A-expressing gene-modified T cells (GMTCs) were produced from healthy donors (HDs) and acute myeloid leukemia (AML) donors. The RapaCasp9-G suicide gene demonstrated better efficiency, and we showed its in vitro functionality in different clinically relevant culture conditions. Moreover, as rapamycin is not pharmacologically inert, we also demonstrated its safe use as part of our therapy.
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Affiliation(s)
- Lucie Bouquet
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25 000, Besançon, France
| | - Elodie Bôle-Richard
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25 000, Besançon, France
| | - Walid Warda
- CanCell Therapeutics, 25 000, Besançon, France
| | | | - Rim Trad
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25 000, Besançon, France
| | - Clémentine Nicod
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25 000, Besançon, France
| | - Rafik Haderbache
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25 000, Besançon, France
| | - Delphine Genin
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25 000, Besançon, France
| | - Christophe Ferrand
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25 000, Besançon, France
- CanCell Therapeutics, 25 000, Besançon, France
| | - Marina Deschamps
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25 000, Besançon, France.
- CanCell Therapeutics, 25 000, Besançon, France.
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Nicod C, da Rocha MN, Warda W, Roussel X, Haderbache R, Seffar E, Trad R, Bouquet L, Goncalves M, Bosdure L, Laude MC, Guiot M, Ferrand C, Deschamps M. CAR-T cells targeting IL-1RAP produced in a closed semiautomatic system are ready for the first phase I clinical investigation in humans. Curr Res Transl Med 2023; 71:103385. [PMID: 36773434 DOI: 10.1016/j.retram.2023.103385] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 07/18/2022] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023]
Abstract
PURPOSE OF THE STUDY The use of chimeric antigen receptor (CAR)-T cells has demonstrated excellent results in B-lymphoid malignancies. The Advanced Therapy Medicinal Products (ATMP) status and good manufacturing practice (GMP) of CAR-T cells require particular conditions of production performed in a pharmaceutical establishment. Our team developed a new medical drug candidate for acute myeloid leukemia (AML), a CAR targeting interleukin-1 receptor accessory protein (IL-1RAP) expressed by leukemia stem cells, which will need to be evaluated in a phase I-IIa clinical trial. During the preclinical development phase, we produced IL-1RAP CAR-T cells in a semi-automated closed system (CliniMACSࣨ Prodigy) using research grade lentiviral particles. PATIENTS AND THE METHODS The purpose of this work was to validate our production process and to characterize our preclinical GMP-like medicinal product. IL-1RAP CAR-T cells were produced from healthy donors in 9 days, either in an semi-automated closed system (with GMP-like compliant conditions) or according to another research protocols, which was used as a reference. RESULTS Based on phenotypic, functional and metabolic analyses, we were able to show that the final product is ready for clinical use. Finally, in a xenograft AML murine model, we demonstrated that the IL-1RAP CAR-T cells generated in a GMP-like environment could eliminate tumor cells and increase overall survival. CONCLUSION We demonstrated that our IL-1RAP CAR-T cell preclinical GMP-like production process meets standard regulatory requirements in terms of CAR-T cell number, subpopulation phenotype and cytotoxic functionality. Our CAR-T cell production process was validated and can be used to produce medicinal IL-1RAP CAR-T cells for the first phase I clinical trial.
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Affiliation(s)
- Clémentine Nicod
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Mathieu Neto da Rocha
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France; CanCell Therapeutics, 25000 Besançon, France
| | - Walid Warda
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France; CanCell Therapeutics, 25000 Besançon, France
| | - Xavier Roussel
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France; Department of Hematology, CHU Besançon, F-25000 Besançon, France
| | - Rafik Haderbache
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Evan Seffar
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Rim Trad
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Lucie Bouquet
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Mathieu Goncalves
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France; Lymphobank S.A.S.U, F-25000 Besançon, France
| | - Léa Bosdure
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Marie-Charlotte Laude
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Mélanie Guiot
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Christophe Ferrand
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France; CanCell Therapeutics, 25000 Besançon, France
| | - Marina Deschamps
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France; CanCell Therapeutics, 25000 Besançon, France.
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Da Rocha MN, Guiot M, Nicod C, Trad R, Bouquet L, Haderbache R, Warda W, Baurand PE, Jouanneau C, Dulieu P, Deschamps M, Ferrand C. Coated recombinant target protein helps explore IL-1RAP CAR T-cell functionality in vitro. Immunol Res 2022; 71:276-282. [PMID: 36456721 PMCID: PMC10060290 DOI: 10.1007/s12026-022-09348-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 11/23/2022] [Indexed: 12/04/2022]
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Trad R, Warda W, Alcazer V, Neto da Rocha M, Berceanu A, Nicod C, Haderbache R, Roussel X, Desbrosses Y, Daguindau E, Renosi F, Roumier C, Bouquet L, Biichle S, Guiot M, Seffar E, Caillot D, Depil S, Robinet E, Salma Y, Deconinck E, Deschamps M, Ferrand C. Chimeric antigen receptor T-cells targeting IL-1RAP: a promising new cellular immunotherapy to treat acute myeloid leukemia. J Immunother Cancer 2022; 10:jitc-2021-004222. [PMID: 35803613 PMCID: PMC9272123 DOI: 10.1136/jitc-2021-004222] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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] [Accepted: 06/27/2022] [Indexed: 11/29/2022] Open
Abstract
Background Acute myeloid leukemia (AML) remains a very difficult disease to cure due to the persistence of leukemic stem cells (LSCs), which are resistant to different lines of chemotherapy and are the basis of refractory/relapsed (R/R) disease in 80% of patients with AML not receiving allogeneic transplantation. Methods In this study, we showed that the interleukin-1 receptor accessory protein (IL-1RAP) protein is overexpressed on the cell surface of LSCs in all subtypes of AML and confirmed it as an interesting and promising target in AML compared with the most common potential AML targets, since it is not expressed by the normal hematopoietic stem cell. After establishing the proof of concept for the efficacy of chimeric antigen receptor (CAR) T-cells targeting IL-1RAP in chronic myeloid leukemia, we hypothesized that third-generation IL-1RAP CAR T-cells could eliminate AML LSCs, where the medical need is not covered. Results We first demonstrated that IL-1RAP CAR T-cells can be produced from AML T-cells at the time of diagnosis and at relapse. In vitro and in vivo, we showed the effectiveness of IL-1RAP CAR T-cells against AML cell lines expressing different levels of IL-1RAP and the cytotoxicity of autologous IL-1RAP CAR T-cells against primary cells from patients with AML at diagnosis or at relapse. In patient-derived relapsed AML xenograft models, we confirmed that IL-1RAP CAR T-cells are able to circulate in peripheral blood and to migrate in the bone marrow and spleen, are cytotoxic against primary AML cells and increased overall survival. Conclusion In conclusion, our preclinical results suggest that IL-1RAP CAR T-based adoptive therapy could be a promising strategy in AML treatment and it warrants the clinical investigation of this CAR T-cell therapy.
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Affiliation(s)
- Rim Trad
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | - Walid Warda
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France.,CanCell Therapeutics, Besancon, France
| | | | - Mathieu Neto da Rocha
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France.,CanCell Therapeutics, Besancon, France
| | - Ana Berceanu
- Clinical Hematology, C.H. Univ Jean Minjoz, Besancon, France
| | | | | | - Xavier Roussel
- Clinical Hematology, C.H. Univ Jean Minjoz, Besancon, France
| | | | | | - Florain Renosi
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | | | - Lucie Bouquet
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | - Sabeha Biichle
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | - Melanie Guiot
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | - Evan Seffar
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | - Denis Caillot
- Clinical Hematology, CHU François Mitterrand, Dijon, France
| | | | | | - Yahya Salma
- Laboratory of Applied Biotechnology (LBA3B), Lebanese University, Tripoli, Lebanon
| | - Eric Deconinck
- Clinical Hematology, C.H. Univ Jean Minjoz, Besancon, France
| | - Marina Deschamps
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France.,CanCell Therapeutics, Besancon, France
| | - Christophe Ferrand
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France .,CanCell Therapeutics, Besancon, France
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Haderbache R, Warda W, Hervouet E, da Rocha MN, Trad R, Allain V, Nicod C, Thieblemeont C, Boissel N, Varlet P, Agha IY, Bouquet L, Guiot M, Venet F, Sujobert P, Roussel X, Rouzaire PO, Caillot D, Casasnovas O, Bories JC, Bachy E, Caillat-Zucman S, Deschamps M, Ferrand C. Droplet digital PCR allows vector copy number assessment and monitoring of experimental CAR T cells in murine xenograft models or approved CD19 CAR T cell-treated patients. J Transl Med 2021; 19:265. [PMID: 34154602 PMCID: PMC8215786 DOI: 10.1186/s12967-021-02925-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 04/25/2021] [Accepted: 06/03/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Genetically engineered chimeric antigen receptor (CAR) T lymphocytes are promising therapeutic tools for cancer. Four CAR T cell drugs, including tisagenlecleucel (tisa-cel) and axicabtagene-ciloleucel (axi-cel), all targeting CD19, are currently approved for treating B cell malignancies. Flow cytometry (FC) remains the standard for monitoring CAR T cells using a recombinant biotinylated target protein. Nevertheless, there is a need for additional tools, and the challenge is to develop an easy, relevant, highly sensitive, reproducible, and inexpensive detection method. Molecular tools can meet this need to specifically monitor long-term persistent CAR T cells. METHODS Based on 2 experimental CAR T cell constructs, IL-1RAP and CS1, we designed 2 quantitative digital droplet (ddPCR) PCR assays. By targeting the 4.1BB/CD3z (28BBz) or 28/CD3z (28z) junction area, we demonstrated that PCR assays can be applied to approved CD19 CAR T drugs. Both 28z and 28BBz ddPCR assays allow determination of the average vector copy number (VCN) per cell. We confirmed that the VCN is dependent on the multiplicity of infection and verified that the VCN of our experimental or GMP-like IL-1RAP CAR T cells met the requirement (< 5 VCN/cell) for delivery to the clinical department, similar to approved axi-cel or tisa-cel drugs. RESULTS 28BBz and 28z ddPCR assays applied to 2 tumoral (acute myeloid leukemia (AML) or multiple myeloma (MM) xenograft humanized NSG mouse models allowed us to quantify the early expansion (up to day 30) of CAR T cells after injection. Interestingly, following initial expansion, when circulating CAR T cells were challenged with the tumor, we noted a second expansion phase. Investigation of the bone marrow, spleen and lung showed that CAR T cells disseminated more within these tissues in mice previously injected with leukemic cell lines. Finally, circulating CAR T cell ddPCR monitoring of R/R acute lymphoid leukemia or diffuse large B cell lymphoma (n = 10 for tisa-cel and n = 7 for axi-cel) patients treated with both approved CAR T cells allowed detection of early expansion, which was highly correlated with FC, as well as long-term persistence (up to 450 days), while FC failed to detect these events. CONCLUSION Overall, we designed and validated 2 ddPCR assays allowing routine or preclinical monitoring of early- and long-term circulating approved or experimental CAR T cells, including our own IL-1RAP CAR T cells, which will be evaluated in an upcoming phase I clinical trial.
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Affiliation(s)
- Rafik Haderbache
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France
| | - Walid Warda
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France
| | - Eric Hervouet
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France
| | - Mathieu Neto da Rocha
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France
| | - Rim Trad
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France
| | - Vincent Allain
- Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Service d'Immunologie, Paris, France
| | - Clementine Nicod
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France
| | - Catherine Thieblemeont
- Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Service Hématologie, Paris, France
| | - Nicolas Boissel
- Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Service Hématologie, Paris, France
| | | | | | - Lucie Bouquet
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France
| | - Melanie Guiot
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France
| | - Fabienne Venet
- Hospices Civils de Lyon, Immunology Laboratory, Edouard Herriot Hospital, Lyon, France
| | - Pierre Sujobert
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service d'Hématologie Biologique, Lyon, France
| | - Xavier Roussel
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France
| | - Paul-Oliver Rouzaire
- UFR de Pharmacie, EA CHELTER 7453, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Denis Caillot
- Hematology Clinical Department, Mitterrand Hospital, Dijon, France
| | | | | | - Emmanuel Bachy
- Hospices Civils de Lyon, Hospital Lyon Sud, Service d'Hématologie Clinique, Lyon, France
| | - Sophie Caillat-Zucman
- Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Service d'Immunologie, Paris, France
| | - Marina Deschamps
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France
| | - Christophe Ferrand
- INSERM UMR1098, Right, EFSBFC, UFC, Laboratoire de Thérapeutique Immuno-Moléculaire Et Cellulaire Des Cancers, 8 rue du Dr Jean François Xavier Girod, 25020, Besançon, France.
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Warda W, Da Rocha MN, Trad R, Haderbache R, Salma Y, Bouquet L, Roussel X, Nicod C, Deschamps M, Ferrand C. Overcoming target epitope masking resistance that can occur on low-antigen-expresser AML blasts after IL-1RAP chimeric antigen receptor T cell therapy using the inducible caspase 9 suicide gene safety switch. Cancer Gene Ther 2021; 28:1365-1375. [PMID: 33414517 PMCID: PMC8636256 DOI: 10.1038/s41417-020-00284-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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] [Received: 09/06/2020] [Revised: 11/27/2020] [Accepted: 12/04/2020] [Indexed: 12/31/2022]
Abstract
Although chimeric antigen receptor CAR) T cell immunotherapies are an undeniable and unequivocal success, knowledge obtained from the monitoring of the first clinical trials targeting the CD19 antigen in B malignancies, either refractory/relapsed acute lymphoid leukemia (ALL) or lymphomas, contributed to the identification of tumor cell escape in about 30–50% of B-ALL. Resistance occurred due to loss of surface expression of the antigen (rCD19−) or to the early disappearance or inactivation of CAR T cells (rCD19+). In a recently reported clinical case, rCD19− relapse resulted from masking of the antigen by the CAR at the surface of B-ALL leukemia cells following the unexpected viral transduction of a leukemic cell present in the cytapheresis sample. The objective of this work was to reproduce this epitope-masking resistance model, in the context of acute myeloid leukemia (AML), based on our immunotherapeutic CAR T cell model targeting the accessory protein of the interleukin-1 receptor (IL-1RAP) expressed by leukemic stem cells. As AML primary blasts express different levels of IL-1RAP, we modeled transduction of different AML tumor cell lines screened for density of antigenic sites with our lentiviral vectors carrying a third-generation IL-1RAP CAR, an iCASP9 suicide gene, and a truncated CD19 surface gene. We demonstrated that primary AML blasts can be easily transduced (74.55 ± 21.29%, n = 4) and that CAR T cytotoxicity to IL-1RAP is inversely correlated with epitope masking in relation to the number of antigenic sites expressed on the surface of IL-1RAP+ lines. Importantly, we showed that, in vitro, a 24-h exposure of IL-1RAP+/CAR+ leukemia lines to Rimiducid eliminated >85% of the cells. We confirmed that the expression of IL-1RAP CAR by an IL-1RAP+ leukemic cell, by decreasing the membrane availability of the targeted antigen, can induce resistance while a high epitope density maintains sensitivity to CAR T cells. Moreover, the presence of the iCASP9/Rimiducid suicide system safety switch makes this immunotherapy approach safe for application in a future phase 1 clinical trial.
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Affiliation(s)
- Walid Warda
- INSERM UMR1098 Right, EFS BFC, Univ. Bourgogne Franche-Comté, 25000, Besançon, France
| | - Mathieu Neto Da Rocha
- INSERM UMR1098 Right, EFS BFC, Univ. Bourgogne Franche-Comté, 25000, Besançon, France
| | - Rim Trad
- INSERM UMR1098 Right, EFS BFC, Univ. Bourgogne Franche-Comté, 25000, Besançon, France
| | - Rafik Haderbache
- INSERM UMR1098 Right, EFS BFC, Univ. Bourgogne Franche-Comté, 25000, Besançon, France
| | - Yahya Salma
- Laboratory of Applied Biotechnology (LBA3B), AZM Center for Research in Biotechnology and its Applications, Lebanese University, Tripoli, 1300, Lebanon
| | - Lucie Bouquet
- INSERM UMR1098 Right, EFS BFC, Univ. Bourgogne Franche-Comté, 25000, Besançon, France
| | - Xavier Roussel
- INSERM UMR1098 Right, EFS BFC, Univ. Bourgogne Franche-Comté, 25000, Besançon, France.,Hematology Department, Hôpital Jean Minjoz, 25000, Besançon, France
| | - Clémentine Nicod
- INSERM UMR1098 Right, EFS BFC, Univ. Bourgogne Franche-Comté, 25000, Besançon, France
| | - Marina Deschamps
- INSERM UMR1098 Right, EFS BFC, Univ. Bourgogne Franche-Comté, 25000, Besançon, France
| | - Christophe Ferrand
- INSERM UMR1098 Right, EFS BFC, Univ. Bourgogne Franche-Comté, 25000, Besançon, France.
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Roussel X, Daguindau E, Berceanu A, Desbrosses Y, Warda W, Neto da Rocha M, Trad R, Deconinck E, Deschamps M, Ferrand C. Acute Myeloid Leukemia: From Biology to Clinical Practices Through Development and Pre-Clinical Therapeutics. Front Oncol 2020; 10:599933. [PMID: 33363031 PMCID: PMC7757414 DOI: 10.3389/fonc.2020.599933] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 08/28/2020] [Accepted: 11/02/2020] [Indexed: 12/19/2022] Open
Abstract
Recent studies have provided several insights into acute myeloid leukemia. Studies based on molecular biology have identified eight functional mutations involved in leukemogenesis, including driver and passenger mutations. Insight into Leukemia stem cells (LSCs) and assessment of cell surface markers have enabled characterization of LSCs from hematopoietic stem and progenitor cells. Clonal evolution has been described as having an effect similar to that of microenvironment alterations. Such biological findings have enabled the development of new targeted drugs, including drug inhibitors and monoclonal antibodies with blockage functions. Some recently approved targeted drugs have resulted in new therapeutic strategies that enhance standard intensive chemotherapy regimens as well as supportive care regimens. Besides the progress made in adoptive immunotherapy, since allogenic hematopoietic stem cell transplantation enabled the development of new T-cell transfer therapies, such as chimeric antigen receptor T-cell and transgenic TCR T-cell engineering, new promising strategies that are investigated.
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Affiliation(s)
- Xavier Roussel
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
- Department of Hematology, University Hospital of Besançon, Besançon, France
| | - Etienne Daguindau
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
- Department of Hematology, University Hospital of Besançon, Besançon, France
| | - Ana Berceanu
- Department of Hematology, University Hospital of Besançon, Besançon, France
| | - Yohan Desbrosses
- Department of Hematology, University Hospital of Besançon, Besançon, France
| | - Walid Warda
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
| | | | - Rim Trad
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
| | - Eric Deconinck
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
- Department of Hematology, University Hospital of Besançon, Besançon, France
| | - Marina Deschamps
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
| | - Christophe Ferrand
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
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Lachat C, Bruyère D, Etcheverry A, Aubry M, Mosser J, Warda W, Herfs M, Hendrick E, Ferrand C, Borg C, Delage-Mourroux R, Feugeas JP, Guittaut M, Hervouet E, Peixoto P. EZH2 and KDM6B Expressions Are Associated with Specific Epigenetic Signatures during EMT in Non Small Cell Lung Carcinomas. Cancers (Basel) 2020; 12:E3649. [PMID: 33291363 PMCID: PMC7762040 DOI: 10.3390/cancers12123649] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 10/28/2020] [Revised: 11/26/2020] [Accepted: 11/28/2020] [Indexed: 01/18/2023] Open
Abstract
The role of Epigenetics in Epithelial Mesenchymal Transition (EMT) has recently emerged. Two epigenetic enzymes with paradoxical roles have previously been associated to EMT, EZH2 (Enhancer of Zeste 2 Polycomb Repressive Complex 2 (PRC2) Subunit), a lysine methyltranserase able to add the H3K27me3 mark, and the histone demethylase KDM6B (Lysine Demethylase 6B), which can remove the H3K27me3 mark. Nevertheless, it still remains unclear how these enzymes, with apparent opposite activities, could both promote EMT. In this study, we evaluated the function of these two enzymes using an EMT-inducible model, the lung cancer A549 cell line. ChIP-seq coupled with transcriptomic analysis showed that EZH2 and KDM6B were able to target and modulate the expression of different genes during EMT. Based on this analysis, we described INHBB, WTN5B, and ADAMTS6 as new EMT markers regulated by epigenetic modifications and directly implicated in EMT induction.
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Affiliation(s)
- Camille Lachat
- UMR1098, RIGHT, Université Bourgogne Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France; (C.L.); (W.W.); (C.F.); (C.B.); (R.D.-M.); (J.-P.F.); (M.G.)
| | - Diane Bruyère
- Laboratory of Experimental Pathology, GIGA-Cancer, University of Liege, 4000 Liege, Belgium; (D.B.); (M.H.); (E.H.)
| | - Amandine Etcheverry
- Service de Génétique Moléculaire et Génomique, CHU Rennes, F-35033 Rennes, France; (A.E.); (M.A.); (J.M.)
- Plate-Forme Génomique Environnementale et Humaine Biosit, Université Rennes1, F-35043 Rennes, France
- UMR 6290, CNRS, Institut de Génétique et Développement de Rennes (IGDR), F-35043 Rennes, France
- UMS 3480 Biosit, Faculté de Médecine, Université Rennes1, UEB, F-35043 Rennes, France
| | - Marc Aubry
- Service de Génétique Moléculaire et Génomique, CHU Rennes, F-35033 Rennes, France; (A.E.); (M.A.); (J.M.)
- Plate-Forme Génomique Environnementale et Humaine Biosit, Université Rennes1, F-35043 Rennes, France
- UMR 6290, CNRS, Institut de Génétique et Développement de Rennes (IGDR), F-35043 Rennes, France
- UMS 3480 Biosit, Faculté de Médecine, Université Rennes1, UEB, F-35043 Rennes, France
| | - Jean Mosser
- Service de Génétique Moléculaire et Génomique, CHU Rennes, F-35033 Rennes, France; (A.E.); (M.A.); (J.M.)
- Plate-Forme Génomique Environnementale et Humaine Biosit, Université Rennes1, F-35043 Rennes, France
- UMR 6290, CNRS, Institut de Génétique et Développement de Rennes (IGDR), F-35043 Rennes, France
- UMS 3480 Biosit, Faculté de Médecine, Université Rennes1, UEB, F-35043 Rennes, France
| | - Walid Warda
- UMR1098, RIGHT, Université Bourgogne Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France; (C.L.); (W.W.); (C.F.); (C.B.); (R.D.-M.); (J.-P.F.); (M.G.)
| | - Michaël Herfs
- Laboratory of Experimental Pathology, GIGA-Cancer, University of Liege, 4000 Liege, Belgium; (D.B.); (M.H.); (E.H.)
| | - Elodie Hendrick
- Laboratory of Experimental Pathology, GIGA-Cancer, University of Liege, 4000 Liege, Belgium; (D.B.); (M.H.); (E.H.)
| | - Christophe Ferrand
- UMR1098, RIGHT, Université Bourgogne Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France; (C.L.); (W.W.); (C.F.); (C.B.); (R.D.-M.); (J.-P.F.); (M.G.)
| | - Christophe Borg
- UMR1098, RIGHT, Université Bourgogne Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France; (C.L.); (W.W.); (C.F.); (C.B.); (R.D.-M.); (J.-P.F.); (M.G.)
| | - Régis Delage-Mourroux
- UMR1098, RIGHT, Université Bourgogne Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France; (C.L.); (W.W.); (C.F.); (C.B.); (R.D.-M.); (J.-P.F.); (M.G.)
| | - Jean-Paul Feugeas
- UMR1098, RIGHT, Université Bourgogne Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France; (C.L.); (W.W.); (C.F.); (C.B.); (R.D.-M.); (J.-P.F.); (M.G.)
| | - Michaël Guittaut
- UMR1098, RIGHT, Université Bourgogne Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France; (C.L.); (W.W.); (C.F.); (C.B.); (R.D.-M.); (J.-P.F.); (M.G.)
- DImaCell Platform, Université Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Eric Hervouet
- UMR1098, RIGHT, Université Bourgogne Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France; (C.L.); (W.W.); (C.F.); (C.B.); (R.D.-M.); (J.-P.F.); (M.G.)
- DImaCell Platform, Université Bourgogne Franche-Comté, F-25000 Besançon, France
- EPIGENExp (EPIgenetics and GENe EXPression Technical Platform), Université Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Paul Peixoto
- UMR1098, RIGHT, Université Bourgogne Franche-Comté, INSERM, EFS BFC, F-25000 Besançon, France; (C.L.); (W.W.); (C.F.); (C.B.); (R.D.-M.); (J.-P.F.); (M.G.)
- EPIGENExp (EPIgenetics and GENe EXPression Technical Platform), Université Bourgogne Franche-Comté, F-25000 Besançon, France
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Gorby C, Sotolongo Bellón J, Wilmes S, Warda W, Pohler E, Fyfe PK, Cozzani A, Ferrand C, Walter MR, Mitra S, Piehler J, Moraga I. Engineered IL-10 variants elicit potent immunomodulatory effects at low ligand doses. Sci Signal 2020; 13:13/649/eabc0653. [PMID: 32934073 DOI: 10.1126/scisignal.abc0653] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Interleukin-10 (IL-10) is a dimeric cytokine with both immunosuppressive and immunostimulatory activities; however, IL-10-based therapies have shown only marginal clinical benefits. Here, we explored whether the stability of the IL-10 receptor complex contributes to the immunomodulatory potency of IL-10. We generated an IL-10 mutant with enhanced affinity for its IL-10Rβ receptor using yeast surface display. Compared to the wild-type cytokine, the affinity-enhanced IL-10 variants recruited IL-10Rβ more efficiently into active cell surface signaling complexes and triggered greater STAT1 and STAT3 activation in human monocytes and CD8+ T cells. These effects, in turn, led to more robust induction of IL-10-mediated gene expression programs at low ligand concentrations in both human cell subsets. IL-10-regulated genes are involved in monocyte energy homeostasis, migration, and trafficking and in CD8+ T cell exhaustion. At nonsaturating doses, IL-10 did not induce key components of its gene expression program, which may explain its lack of efficacy in clinical settings. Our engineered IL-10 variant showed a more robust bioactivity profile than that of wild-type IL-10 at low doses in monocytes and CD8+ T cells. Moreover, CAR-modified T cells expanded with the engineered IL-10 variant displayed superior cytolytic activity than those expanded with wild-type IL-10. Our study provides insights into how IL-10 receptor complex stability fine-tunes IL-10 biology and opens new opportunities to revitalize failed IL-10 therapies.
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Affiliation(s)
- Claire Gorby
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee DD15EH, UK
| | - Junel Sotolongo Bellón
- Department of Biology and Center for Cellular Nanoanalytics (CellNanOs), University of Osnabrück, Barbarastraße 11, 49076 Osnabrück, Germany
| | - Stephan Wilmes
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee DD15EH, UK
| | - Walid Warda
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Elizabeth Pohler
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee DD15EH, UK
| | - Paul K Fyfe
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee DD15EH, UK
| | - Adeline Cozzani
- Université de Lille, INSERM UMR1277 CNRS UMR9020-CANTHER and Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France
| | - Christophe Ferrand
- Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Mark R Walter
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35243, USA
| | - Suman Mitra
- Université de Lille, INSERM UMR1277 CNRS UMR9020-CANTHER and Institut pour la Recherche sur le Cancer de Lille (IRCL), Lille, France
| | - Jacob Piehler
- Department of Biology and Center for Cellular Nanoanalytics (CellNanOs), University of Osnabrück, Barbarastraße 11, 49076 Osnabrück, Germany
| | - Ignacio Moraga
- Division of Cell Signalling and Immunology, School of Life Sciences, University of Dundee, Dundee DD15EH, UK.
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Warda W, Neto Da Rocha M, Rim T, Deschamps M, Ferrand C. Stratégie de développement d’un CAR-T-cell ciblant IL1-RAP sécurisé par un gène suicide. Transfus Clin Biol 2019. [DOI: 10.1016/j.tracli.2019.06.303] [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: 10/26/2022]
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Neto Da Rocha M, Trad R, Warda W, Haderbache R, Bouquet L, Nicod C, Deschamps M, Ferrand C. [IL-1RAP as a candidate for CAR T-cells immunotherapy]. Med Sci (Paris) 2019; 35:497-500. [PMID: 31274074 DOI: 10.1051/medsci/2019105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Mathieu Neto Da Rocha
- Établissement français du sang de Bourgogne Franche-Comté, Inserm UMR1098 - Université de Bourgogne Franche-Comté, 8, rue du Dr Jean-François-Xavier Girod, BP1937, 25020 Besançon, France
| | - Rim Trad
- Établissement français du sang de Bourgogne Franche-Comté, Inserm UMR1098 - Université de Bourgogne Franche-Comté, 8, rue du Dr Jean-François-Xavier Girod, BP1937, 25020 Besançon, France
| | - Walid Warda
- Établissement français du sang de Bourgogne Franche-Comté, Inserm UMR1098 - Université de Bourgogne Franche-Comté, 8, rue du Dr Jean-François-Xavier Girod, BP1937, 25020 Besançon, France
| | - Rafik Haderbache
- Établissement français du sang de Bourgogne Franche-Comté, Inserm UMR1098 - Université de Bourgogne Franche-Comté, 8, rue du Dr Jean-François-Xavier Girod, BP1937, 25020 Besançon, France
| | - Lucie Bouquet
- Établissement français du sang de Bourgogne Franche-Comté, Inserm UMR1098 - Université de Bourgogne Franche-Comté, 8, rue du Dr Jean-François-Xavier Girod, BP1937, 25020 Besançon, France
| | - Clémentine Nicod
- Établissement français du sang de Bourgogne Franche-Comté, Inserm UMR1098 - Université de Bourgogne Franche-Comté, 8, rue du Dr Jean-François-Xavier Girod, BP1937, 25020 Besançon, France
| | - Marina Deschamps
- Établissement français du sang de Bourgogne Franche-Comté, Inserm UMR1098 - Université de Bourgogne Franche-Comté, 8, rue du Dr Jean-François-Xavier Girod, BP1937, 25020 Besançon, France
| | - Christophe Ferrand
- Établissement français du sang de Bourgogne Franche-Comté, Inserm UMR1098 - Université de Bourgogne Franche-Comté, 8, rue du Dr Jean-François-Xavier Girod, BP1937, 25020 Besançon, France
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12
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Warda W, Larosa F, Neto Da Rocha M, Trad R, Deconinck E, Fajloun Z, Faure C, Caillot D, Moldovan M, Valmary-Degano S, Biichle S, Daguindau E, Garnache-Ottou F, Tabruyn S, Adotevi O, Deschamps M, Ferrand C. CML Hematopoietic Stem Cells Expressing IL1RAP Can Be Targeted by Chimeric Antigen Receptor-Engineered T Cells. Cancer Res 2018; 79:663-675. [PMID: 30514753 DOI: 10.1158/0008-5472.can-18-1078] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/09/2018] [Accepted: 11/29/2018] [Indexed: 12/16/2022]
Abstract
Chronic myeloid leukemia (CML) is a chronic disease resulting in myeloid cell expansion through expression of the BCR-ABL1 fusion transcript. Tyrosine kinase inhibitors (TKI) have significantly increased survival of patients with CML, and deep responders may consider stopping the treatment. However, more than 50% of patients relapse and restart TKI, subsequently suffering unknown toxicity. Because CML is a model immune system-sensitive disease, we hypothesize that chimeric antigen receptor (CAR) T cells targeting IL1 receptor-associated protein (IL1RAP) in quiescent CML stem cells may offer an opportunity for a permanent cure. In this study, we produced and molecularly characterized a specific monoclonal anti-IL1RAP antibody from which fragment antigen-binding nucleotide coding sequences were cloned as a single chain into a lentiviral backbone and secured with the suicide gene iCASP9/rimiducid system. Our CAR T-cell therapy exhibited cytotoxicity against both leukemic stem cells and, to a lesser extent, monocytes expressing IL1RAP, with no apparent effect on the hematopoietic system, including CD34+ stem cells. This suggests IL1RAP as a tumor-associated antigen for immunotherapy cell targeting. IL1RAP CAR T cells were activated in the presence of IL1RAP+ cell lines or primary CML cells, resulting in secretion of proinflammatory cytokines and specifically killing in vitro and in a xenograft murine model. Overall, we demonstrate the proof of concept of a CAR T-cell immunotherapy approach in the context of CML that is applicable for young patients and primary TKI-resistant, intolerant, or allograft candidate patients. SIGNIFICANCE: These findings present the first characterization and proof of concept of a chimeric antigen receptor directed against IL1RAP expressed by leukemic stem cells in the context of CML.
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Affiliation(s)
- Walid Warda
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France.,Laboratory of Applied Biotechnology, Azm Centre for Research in Biotechnology and its Applications, EDST and Faculty of Sciences 3, Lebanese University, Tripoli, Liban
| | - Fabrice Larosa
- Department of Hematology, University Hospital of Besancon, Besancon, France
| | | | - Rim Trad
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France
| | - Eric Deconinck
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France.,Department of Hematology, University Hospital of Besancon, Besancon, France
| | - Ziad Fajloun
- Laboratory of Applied Biotechnology, Azm Centre for Research in Biotechnology and its Applications, EDST and Faculty of Sciences 3, Lebanese University, Tripoli, Liban
| | - Cyril Faure
- Department of Internal Medicine, Hospital of Haute Saone, Vesoul, France
| | - Denis Caillot
- Department of Hematology, University Hospital of Dijon, Dijon, France
| | - Marius Moldovan
- Department of Internal Medicine, Hospital Nord Franche-Comté, Belfort, France
| | | | - Sabeha Biichle
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France
| | - Etienne Daguindau
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France.,Department of Hematology, University Hospital of Besancon, Besancon, France
| | | | | | - Olivier Adotevi
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France
| | - Marina Deschamps
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France
| | - Christophe Ferrand
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France.
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