Apoptosis Research Centre, Biomedical Sciences, National University of Ireland Galway, Newcastle Road, Galway, H91 W2TY, Ireland.
ONK Therapeutics Ltd., Galway, Ireland.
Cancer Immunol Immunother. 2020 Mar;69(3):421-434. doi: 10.1007/s00262-019-02477-8. Epub 2020 Jan 9.
Multiple myeloma (MM) is a clonal plasma cell malignancy typically associated with the high and uniform expression of the CD38 transmembrane glycoprotein. Daratumumab is a humanized IgG1κ CD38 monoclonal antibody (MoAb) which has demonstrated impressive single agent activity even in relapsed refractory MM patients as well as strong synergy with other anti-MM drugs. Natural Killer (NK) cells are cytotoxic immune effector cells that mediate in vivo tumour immunosurveillance. NK cells also play an important role during MoAb therapy by inducing antibody dependent cellular cytotoxicity (ADCC) via their FcγRIII (CD16) receptor. Furthermore, 15% of the population express a naturally occurring variant of CD16 harbouring a single-point polymorphism (F158V). However, the contribution of NK cells to the efficacy of daratumumab remains debatable as clinical data clearly indicate the rapid depletion of CD38 peripheral blood NK cells in patients upon daratumumab administration. In contrast, CD38 peripheral blood NK cells have been shown to survive daratumumab mediated fratricide in vivo, while still retaining their potent anti-MM cytolytic effector functions ex vivo. Therefore, we hypothesize that transiently expressing the CD16 receptor using a "safe" mRNA electroporation-based approach on CD38 NK cells in combination with daratumumab could represent a novel therapeutic option for treatment of MM. In the present study, we investigate a NK cell line (KHYG-1), derived from a patient with aggressive NK cell leukemia, as a platform for generating CD38 NK cells expressing CD16 which can be administered as an "off-the-shelf" therapy to target both CD38 and CD38 tumour clones in patients receiving daratumumab.
多发性骨髓瘤(MM)是一种克隆性浆细胞恶性肿瘤,通常与 CD38 跨膜糖蛋白的高表达和均匀表达相关。达雷妥尤单抗是一种人源化 IgG1κ CD38 单克隆抗体(MoAb),即使在复发/难治性 MM 患者中,它也具有令人印象深刻的单药活性,并且与其他抗 MM 药物具有很强的协同作用。自然杀伤(NK)细胞是细胞毒性免疫效应细胞,介导体内肿瘤免疫监视。NK 细胞在 MoAb 治疗中也通过其 FcγRIII(CD16)受体诱导抗体依赖性细胞毒性(ADCC)发挥重要作用。此外,15%的人群表达一种携带单点多态性(F158V)的天然存在的 CD16 变体。然而,NK 细胞对达雷妥尤单抗疗效的贡献仍存在争议,因为临床数据清楚地表明,在给予达雷妥尤单抗后,患者外周血 CD38 NK 细胞迅速耗竭。相比之下,已证明 CD38 外周血 NK 细胞在体内可存活达雷妥尤单抗介导的细胞自杀,同时仍保持其在外周血中强大的抗 MM 细胞溶解效应功能。因此,我们假设使用基于“安全”mRNA 电穿孔的方法在外周血 CD38 NK 细胞上瞬时表达 CD16 受体,结合达雷妥尤单抗,可能为治疗 MM 提供一种新的治疗选择。在本研究中,我们研究了一种源自侵袭性 NK 细胞白血病患者的 NK 细胞系(KHYG-1),作为一种平台来产生表达 CD16 的 CD38 NK 细胞,可作为一种“现成”疗法,用于靶向接受达雷妥尤单抗治疗的患者的 CD38 和 CD38 肿瘤克隆。