Cellectis Inc, New York, NY, United States.
Cellectis, Paris, France.
Front Immunol. 2023 May 12;14:1172681. doi: 10.3389/fimmu.2023.1172681. eCollection 2023.
Adoptive cell therapy based on chimeric antigen receptor (CAR)-engineered T-cells has proven to be lifesaving for many cancer patients. However, its therapeutic efficacy has so far been restricted to only a few malignancies, with solid tumors proving to be especially recalcitrant to efficient therapy. Poor intra-tumor infiltration by T cells and T cell dysfunction due to a desmoplastic, immunosuppressive microenvironment are key barriers for CAR T-cell success against solid tumors. Cancer-associated fibroblasts (CAFs) are critical components of the tumor stroma, evolving specifically within the tumor microenvironment (TME) in response to tumor cell cues. The CAF secretome is a significant contributor to the extracellular matrix and a plethora of cytokines and growth factors that induce immune suppression. Together they form a physical and chemical barrier which induces a T cell-excluding 'cold' TME. CAF depletion in stroma rich solid tumors can thus provide an opportunity to convert immune evasive tumors susceptible to tumor-antigen CAR T-cell cytotoxicity. Using our TALEN-based gene editing platform we engineered non-alloreactive, immune evasive CAR T-cells (termed UCAR T-cells) targeting the unique CAF marker Fibroblast Activation Protein, alpha (FAP). In an orthotopic mouse model of triple-negative breast cancer (TNBC) composed of patient derived-CAFs and tumor cells, we demonstrate the efficacy of our engineered FAP UCAR T-cells in CAF depletion, reduction of desmoplasia and successful tumor infiltration. Furthermore, while previously resistant, pre-treatment with FAP UCAR T-cells now sensitized these tumors to Mesothelin (Meso) UCAR T-cell infiltration and anti-tumor cytotoxicity. Combination therapy of FAP UCAR, Meso UCAR T cells and the checkpoint inhibitor anti-PD-1 significantly reduced tumor burden and prolonged mice survival. Our study thus proposes a novel treatment paradigm for successful CAR T-cell immunotherapy against stroma-rich solid tumors.
嵌合抗原受体 (CAR)-修饰 T 细胞的过继细胞疗法已被证明对许多癌症患者具有救生作用。然而,其治疗效果迄今为止仅限于少数几种恶性肿瘤,实体瘤被证明对有效治疗特别具有抵抗力。T 细胞在肿瘤内的渗透不良和由于促结缔组织形成的、免疫抑制的微环境导致的 T 细胞功能障碍是 CAR T 细胞对抗实体瘤成功的关键障碍。癌症相关成纤维细胞 (CAF) 是肿瘤基质的关键组成部分,它们在肿瘤微环境 (TME) 中特异性地演变,以响应肿瘤细胞的信号。CAF 分泌组是细胞外基质和众多细胞因子和生长因子的重要贡献者,这些因子诱导免疫抑制。它们共同形成一种物理和化学屏障,诱导 T 细胞排斥的“冷”TME。因此,富含基质的实体瘤中 CAF 的耗竭为将免疫逃避的肿瘤转化为对肿瘤抗原 CAR T 细胞细胞毒性敏感的肿瘤提供了机会。我们使用基于 TALEN 的基因编辑平台,设计了靶向独特的 CAF 标志物成纤维细胞激活蛋白,α (FAP) 的非同种异体反应性、免疫逃避的 CAR T 细胞(称为 UCAR T 细胞)。在由患者衍生的 CAF 和肿瘤细胞组成的三阴性乳腺癌 (TNBC) 原位小鼠模型中,我们证明了我们设计的靶向 FAP 的 UCAR T 细胞在 CAF 耗竭、减少促结缔组织形成和成功肿瘤渗透方面的功效。此外,虽然以前具有抗性,但用 FAP UCAR T 细胞预处理现在使这些肿瘤对间皮素 (Meso) UCAR T 细胞渗透和抗肿瘤细胞毒性敏感。FAP UCAR、Meso UCAR T 细胞和检查点抑制剂抗 PD-1 的联合治疗显著降低了肿瘤负担并延长了小鼠的存活时间。因此,我们的研究提出了一种针对富含基质的实体瘤成功 CAR T 细胞免疫治疗的新治疗范例。
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