Department of Pathology, Case Western Reserve University, Cleveland, Ohio.
Department of Artificial Intelligence and Informatics, Mayo Clinic, Jacksonville, Florida.
Cancer Discov. 2022 Aug 5;12(8):1886-1903. doi: 10.1158/2159-8290.CD-21-1586.
UNLABELLED: Chimeric antigen receptor T-cell (CAR-T cell) therapy directed at CD19 produces durable remissions in the treatment of relapsed/refractory non-Hodgkin lymphoma (NHL). Nonetheless, many patients receiving CD19 CAR-T cells fail to respond for unknown reasons. To reveal changes in 4-1BB-based CD19 CAR-T cells and identify biomarkers of response, we used single-cell RNA sequencing and protein surface marker profiling of patient CAR-T cells pre- and postinfusion into patients with NHL. At the transcriptional and protein levels, we note the evolution of CAR-T cells toward a nonproliferative, highly differentiated, and exhausted state, with an enriched exhaustion profile in CAR-T cells of patients with poor response marked by TIGIT expression. Utilizing in vitro and in vivo studies, we demonstrate that TIGIT blockade alone improves the antitumor function of CAR-T cells. Altogether, we provide evidence of CAR-T cell dysfunction marked by TIGIT expression driving a poor response in patients with NHL. SIGNIFICANCE: This is the first study investigating the mechanisms linked to CAR-T patient responses based on the sequential analysis of manufactured and infused CAR-T cells using single-cell RNA and protein expression data. Furthermore, our findings are the first to demonstrate an improvement of CAR-T cell efficacy with TIGIT inhibition alone. This article is highlighted in the In This Issue feature, p. 1825.
未标记:嵌合抗原受体 T 细胞(CAR-T 细胞)疗法针对 CD19,在治疗复发/难治性非霍奇金淋巴瘤(NHL)方面产生持久缓解。尽管如此,许多接受 CD19 CAR-T 细胞治疗的患者由于未知原因未能产生反应。为了揭示基于 4-1BB 的 CD19 CAR-T 细胞的变化并确定反应的生物标志物,我们使用单细胞 RNA 测序和蛋白表面标志物分析对 NHL 患者进行 CAR-T 细胞输注前后的患者 CAR-T 细胞。在转录和蛋白水平上,我们注意到 CAR-T 细胞向非增殖、高度分化和耗竭状态的演变,并且在对治疗反应不佳的患者的 CAR-T 细胞中,耗竭特征丰富,其特征是 TIGIT 表达。利用体外和体内研究,我们证明了单独阻断 TIGIT 可改善 CAR-T 细胞的抗肿瘤功能。总之,我们提供了证据表明,CAR-T 细胞功能障碍与 TIGIT 表达有关,这导致 NHL 患者的反应不佳。
意义:这是第一项使用单细胞 RNA 和蛋白表达数据对制造和输注的 CAR-T 细胞进行序贯分析,以研究与 CAR-T 患者反应相关的机制的研究。此外,我们的研究结果首次证明单独抑制 TIGIT 可提高 CAR-T 细胞的疗效。本文在本期特色文章中进行了重点介绍,第 1825 页。
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