Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
Department of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
J Immunother Cancer. 2023 Jun;11(6). doi: 10.1136/jitc-2023-006863. Epub 2023 Jun 23.
BACKGROUND: Cancer immunotherapies can produce complete therapeutic responses, however, outcomes in ovarian cancer (OC) are modest. While adoptive T-cell transfer (ACT) has been evaluated in OC, durable effects are rare. Poor therapeutic efficacy is likely multifactorial, stemming from limited antigen recognition, insufficient tumor targeting due to a suppressive tumor microenvironment (TME), and limited intratumoral accumulation/persistence of infused T cells. Importantly, host T cells infiltrate tumors, and ACT approaches that leverage endogenous tumor-infiltrating T cells for antitumor immunity could effectively magnify therapeutic responses. METHODS: Using retroviral transduction, we have generated T cells that secrete a folate receptor alpha (FRα)-directed bispecific T-cell engager (FR-B T cells), a tumor antigen commonly overexpressed in OC and other tumor types. The antitumor activity and therapeutic efficacy of FR-B T cells was assessed using FRα+ cancer cell lines, OC patient samples, and preclinical tumor models with accompanying mechanistic studies. Different cytokine stimulation of T cells (interleukin (IL)-2+IL-7 vs IL-2+IL-15) during FR-B T cell production and the resulting impact on therapeutic outcome following ACT was also assessed. RESULTS: FR-B T cells efficiently lysed FRα+ cell lines, targeted FRα+ OC patient tumor cells, and were found to engage and activate patient T cells present in the TME through secretion of T cell engagers. Additionally, FR-B T cell therapy was effective in an immunocompetent in vivo OC model, with response duration dependent on both endogenous T cells and FR-B T cell persistence. IL-2/IL-15 preconditioning prior to ACT produced less differentiated FR-B T cells and enhanced therapeutic efficacy, with mechanistic studies revealing preferential accumulation of TCF-1+CD39-CD69- stem-like CD8+ FR B T cells in the peritoneal cavity over solid tumors. CONCLUSIONS: These findings highlight the therapeutic potential of FR-B T cells in OC and suggest FR-B T cells can persist in extratumoral spaces while actively directing antitumor immunity. As the therapeutic activity of infused T cell therapies in solid tumor indications is often limited by poor intratumoral accumulation of transferred T cells, engager-secreting T cells that can effectively leverage endogenous immunity may have distinct mechanistic advantages for enhancing therapeutic responses rates.
背景:癌症免疫疗法可以产生完全的治疗反应,然而,卵巢癌(OC)的结果并不理想。虽然过继性 T 细胞转移(ACT)已在 OC 中进行了评估,但持久的疗效很少见。疗效不佳可能是多因素的,源于有限的抗原识别、由于抑制性肿瘤微环境(TME)导致的肿瘤靶向不足,以及输注的 T 细胞在肿瘤内的积累/持续存在有限。重要的是,宿主 T 细胞浸润肿瘤,并且利用内源性肿瘤浸润 T 细胞进行抗肿瘤免疫的 ACT 方法可以有效地放大治疗反应。
方法:我们使用逆转录病毒转导,生成了分泌叶酸受体α(FRα)定向双特异性 T 细胞衔接器(FR-B T 细胞)的 T 细胞,FRα 是 OC 和其他肿瘤类型中常见的过度表达的肿瘤抗原。使用 FRα+癌细胞系、OC 患者样本和伴随机制研究的临床前肿瘤模型评估了 FR-B T 细胞的抗肿瘤活性和治疗效果。还评估了 FR-B T 细胞产生过程中不同细胞因子(白细胞介素(IL)-2+IL-7 与 IL-2+IL-15)对 T 细胞的刺激及其对 ACT 后治疗效果的影响。
结果:FR-B T 细胞有效地裂解 FRα+细胞系,靶向 FRα+OC 患者肿瘤细胞,并通过 T 细胞衔接器的分泌发现与肿瘤微环境中的 FRα+患者 T 细胞结合并激活它们。此外,FR-B T 细胞治疗在免疫活性体内 OC 模型中有效,反应持续时间取决于内源性 T 细胞和 FR-B T 细胞的持续存在。ACT 前进行 IL-2/IL-15 预处理会产生分化程度较低的 FR-B T 细胞,并增强治疗效果,机制研究表明,在腹腔中比实体瘤中更优先积累 TCF-1+CD39-CD69-干细胞样 CD8+FRβT 细胞。
结论:这些发现强调了 FR-B T 细胞在 OC 中的治疗潜力,并表明 FR-B T 细胞可以在肿瘤外空间中持续存在,同时积极指导抗肿瘤免疫。由于输注 T 细胞疗法在实体瘤适应证中的治疗活性通常受到转移 T 细胞在肿瘤内积累不良的限制,因此能够有效地利用内源性免疫的衔接器分泌 T 细胞可能具有增强治疗反应率的独特机制优势。
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