Brain Tumor Lab, Department of Neurosurgery, Biotherapeutics Development Lab, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island02908, USA.
Clin Cancer Res. 2012 Nov 1;18(21):5949-60. doi: 10.1158/1078-0432.CCR-12-0319. Epub 2012 Sep 10.
PURPOSE: Glioblastoma multiforme (GBM) remains highly incurable, with frequent recurrences after standard therapies of maximal surgical resection, radiation, and chemotherapy. To address the need for new treatments, we have undertaken a chimeric antigen receptor (CAR) "designer T cell" (dTc) immunotherapeutic strategy by exploiting interleukin (IL)13 receptor α-2 (IL13Rα2) as a GBM-selective target. EXPERIMENTAL DESIGN: We tested a second-generation IL13 "zetakine" CAR composed of a mutated IL13 extracellular domain linked to intracellular signaling elements of the CD28 costimulatory molecule and CD3ζ. The aim of the mutation (IL13.E13K.R109K) was to enhance selectivity of the CAR for recognition and killing of IL13Rα2(+) GBMs while sparing normal cells bearing the composite IL13Rα1/IL4Rα receptor. RESULTS: Our aim was partially realized with improved recognition of tumor and reduced but persisting activity against normal tissue IL13Rα1(+) cells by the IL13.E13K.R109K CAR. We show that these IL13 dTcs were efficient in killing IL13Rα2(+) glioma cell targets with abundant secretion of cytokines IL2 and IFNγ, and they displayed enhanced tumor-induced expansion versus control unmodified T cells in vitro. In an in vivo test with a human glioma xenograft model, single intracranial injections of IL13 dTc into tumor sites resulted in marked increases in animal survivals. CONCLUSIONS: These data raise the possibility of immune targeting of diffusely invasive GBM cells either via dTc infusion into resection cavities to prevent GBM recurrence or via direct stereotactic injection of dTcs to suppress inoperable or recurrent tumors. Systemic administration of these IL13 dTc could be complicated by reaction against normal tissues expressing IL13Ra1.
目的:多形性胶质母细胞瘤(GBM)仍然难以治愈,在最大程度的手术切除、放疗和化疗的标准治疗后经常复发。为了满足新治疗方法的需求,我们利用白细胞介素(IL)13 受体 α-2(IL13Rα2)作为 GBM 选择性靶点,采用嵌合抗原受体(CAR)“设计 T 细胞”(dTc)免疫治疗策略。
实验设计:我们测试了由突变的 IL13 细胞外结构域与 CD28 共刺激分子和 CD3ζ 的细胞内信号元件连接而成的第二代 IL13“zetakine”CAR。该突变(IL13.E13K.R109K)的目的是增强 CAR 对 IL13Rα2(+)GBM 的识别和杀伤作用的选择性,同时保留表达复合 IL13Rα1/IL4Rα 受体的正常细胞。
结果:我们的目标部分实现了,通过 IL13.E13K.R109K CAR 对肿瘤的识别得到了改善,对正常组织 IL13Rα1(+)细胞的活性降低,但仍然存在。我们表明,这些 IL13 dTc 在杀伤富含细胞因子 IL2 和 IFNγ 的 IL13Rα2(+)神经胶质瘤细胞靶标方面非常有效,并且与对照未修饰 T 细胞相比,它们在体外显示出增强的肿瘤诱导扩增。在人胶质母细胞瘤异种移植模型的体内测试中,IL13 dTc 单次颅内注射到肿瘤部位导致动物存活率显著增加。
结论:这些数据提出了通过 dTc 输注到切除腔中以防止 GBM 复发来靶向弥漫性浸润性 GBM 细胞的免疫治疗的可能性,或者通过直接立体定向注射 dTc 来抑制不可手术或复发性肿瘤。这些 IL13 dTc 的全身给药可能会因针对表达 IL13Ra1 的正常组织的反应而变得复杂。
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