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PD-1 和 TIGIT 的下调分别显著影响了靶向 CD19 的 CAR T 细胞的效应器和早期记忆表型。

PD-1 and TIGIT downregulation distinctly affect the effector and early memory phenotypes of CD19-targeting CAR T cells.

机构信息

Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea; Curocell Inc., Daejeon 34109, Republic of Korea.

Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea; Curocell Inc., Daejeon 34109, Republic of Korea.

出版信息

Mol Ther. 2022 Feb 2;30(2):579-592. doi: 10.1016/j.ymthe.2021.10.004. Epub 2021 Oct 8.


DOI:10.1016/j.ymthe.2021.10.004
PMID:34628052
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8821960/
Abstract

CD19-targeting chimeric antigen receptor (CAR) T cells have become an important therapeutic option for patients with relapsed and refractory B cell malignancies. However, a significant portion of patients still do not benefit from the therapy owing to various resistance mechanisms, including high expression of multiple inhibitory immune checkpoint receptors. Here, we report a lentiviral two-in-one CAR T approach in which two checkpoint receptors are downregulated simultaneously by a dual short hairpin RNA cassette integrated into a CAR vector. Using this system, we evaluated CD19-targeting CAR T cells in the context of four different checkpoint combinations-PD-1/TIM-3, PD-1/LAG-3, PD-1/CTLA-4, and PD-1/TIGIT-and found that CAR T cells with PD-1/TIGIT downregulation uniquely exerted synergistic antitumor effects. Importantly, functional and phenotypic analyses suggested that downregulation of PD-1 enhances short-term effector function, whereas downregulation of TIGIT is primarily responsible for maintaining a less differentiated/exhausted state, providing a potential mechanism for the observed synergy. The PD-1/TIGIT-downregulated CAR T cells generated from diffuse large B cell lymphoma patient-derived T cells also showed robust antitumor activity and significantly improved persistence in vivo. The efficacy and safety of PD-1/TIGIT-downregulated CD19-targeting CAR T cells are currently being evaluated in adult patients with relapsed or refractory large B cell lymphoma (ClinicalTrials.gov: NCT04836507).

摘要

嵌合抗原受体 (CAR) T 细胞靶向 CD19 已成为复发和难治性 B 细胞恶性肿瘤患者的重要治疗选择。然而,由于多种耐药机制,包括多种抑制性免疫检查点受体的高表达,仍有相当一部分患者无法从该治疗中获益。在这里,我们报告了一种基于慢病毒的双靶 CAR T 方法,其中两个检查点受体通过整合到 CAR 载体中的双短发夹 RNA 盒同时下调。使用该系统,我们在四种不同的检查点组合(PD-1/TIM-3、PD-1/LAG-3、PD-1/CTLA-4 和 PD-1/TIGIT)的背景下评估了 CD19 靶向 CAR T 细胞,发现 PD-1/TIGIT 下调的 CAR T 细胞具有独特的协同抗肿瘤作用。重要的是,功能和表型分析表明,PD-1 的下调增强了短期效应功能,而 TIGIT 的下调主要负责维持较少分化/耗竭状态,为观察到的协同作用提供了潜在机制。还从弥漫性大 B 细胞淋巴瘤患者来源的 T 细胞中生成的具有 PD-1/TIGIT 下调的 CAR T 细胞也显示出强大的抗肿瘤活性,并显著提高了体内持久性。目前正在对复发或难治性大 B 细胞淋巴瘤的成年患者进行 PD-1/TIGIT 下调的 CD19 靶向 CAR T 细胞的疗效和安全性评估(ClinicalTrials.gov:NCT04836507)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/572f/8821960/7b6a5c603c99/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/572f/8821960/7b6a5c603c99/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/572f/8821960/7b6a5c603c99/fx1.jpg

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[9]
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[10]
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本文引用的文献

[1]
Long-Term Follow-Up of Anti-CD19 Chimeric Antigen Receptor T-Cell Therapy.

J Clin Oncol. 2020-11-10

[2]
A guide to cancer immunotherapy: from T cell basic science to clinical practice.

Nat Rev Immunol. 2020-5-20

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CD226CD8 T Cells Are a Prerequisite for Anti-TIGIT Immunotherapy.

Cancer Immunol Res. 2020-7

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4-1BB costimulation promotes CAR T cell survival through noncanonical NF-κB signaling.

Sci Signal. 2020-3-31

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Impaired Death Receptor Signaling in Leukemia Causes Antigen-Independent Resistance by Inducing CAR T-cell Dysfunction.

Cancer Discov. 2020-4

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'Off-the-shelf' allogeneic CAR T cells: development and challenges.

Nat Rev Drug Discov. 2020-1-3

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CRISPR-Cas9 disruption of PD-1 enhances activity of universal EGFRvIII CAR T cells in a preclinical model of human glioblastoma.

J Immunother Cancer. 2019-11-14

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Engineered triple inhibitory receptor resistance improves anti-tumor CAR-T cell performance via CD56.

Nat Commun. 2019-9-11

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A TIGIT-based chimeric co-stimulatory switch receptor improves T-cell anti-tumor function.

J Immunother Cancer. 2019-9-9

[10]
PD-1 silencing impairs the anti-tumor function of chimeric antigen receptor modified T cells by inhibiting proliferation activity.

J Immunother Cancer. 2019-8-7

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