Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Cancer Discov. 2023 Jul 7;13(7):1636-1655. doi: 10.1158/2159-8290.CD-22-1175.
UNLABELLED: Chimeric antigen receptor (CAR) T cell therapy has shown promise in treating hematologic cancers, but resistance is common and efficacy is limited in solid tumors. We found that CAR T cells autonomously propagate epigenetically programmed type I interferon signaling through chronic stimulation, which hampers antitumor function. EGR2 transcriptional regulator knockout not only blocks this type I interferon-mediated inhibitory program but also independently expands early memory CAR T cells with improved efficacy against liquid and solid tumors. The protective effect of EGR2 deletion in CAR T cells against chronic antigen-induced exhaustion can be overridden by interferon-β exposure, suggesting that EGR2 ablation suppresses dysfunction by inhibiting type I interferon signaling. Finally, a refined EGR2 gene signature is a biomarker for type I interferon-associated CAR T cell failure and shorter patient survival. These findings connect prolonged CAR T cell activation with deleterious immunoinflammatory signaling and point to an EGR2-type I interferon axis as a therapeutically amenable biological system. SIGNIFICANCE: To improve CAR T cell therapy outcomes, modulating molecular determinants of CAR T cell-intrinsic resistance is crucial. Editing the gene encoding the EGR2 transcriptional regulator renders CAR T cells impervious to type I interferon pathway-induced dysfunction and improves memory differentiation, thereby addressing major barriers to progress for this emerging class of cancer immunotherapies. This article is highlighted in the In This Issue feature, p. 1501.
未标记:嵌合抗原受体 (CAR) T 细胞疗法在治疗血液系统癌症方面显示出前景,但在实体瘤中,耐药性很常见,疗效有限。我们发现,CAR T 细胞通过慢性刺激自主地进行表观遗传编程的 I 型干扰素信号传递,这会阻碍抗肿瘤功能。EGR2 转录调节因子敲除不仅阻断了这种 I 型干扰素介导的抑制程序,而且还独立地扩增了早期记忆 CAR T 细胞,提高了对液体和固体肿瘤的疗效。EGR2 缺失在 CAR T 细胞中对慢性抗原诱导的衰竭的保护作用可以被干扰素-β暴露所克服,这表明 EGR2 缺失通过抑制 I 型干扰素信号来抑制功能障碍。最后,精细的 EGR2 基因特征是与 I 型干扰素相关的 CAR T 细胞衰竭和患者生存时间较短的生物标志物。这些发现将 CAR T 细胞的长期激活与有害的免疫炎症信号联系起来,并指出 EGR2-I 型干扰素轴作为一种可治疗的生物系统。
意义:为了提高 CAR T 细胞治疗的效果,调节 CAR T 细胞内在耐药性的分子决定因素至关重要。编辑编码 EGR2 转录调节因子的基因使 CAR T 细胞不易受到 I 型干扰素途径诱导的功能障碍的影响,并改善记忆分化,从而解决了这一新兴癌症免疫疗法的主要进展障碍。本文在本期的特色文章中进行了重点介绍,第 1501 页。
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