Endogenous CD28 drives CAR T cell responses in multiple myeloma.
作者信息
Lieberman Mackenzie M, Tong Jason H, Odukwe Nkechi U, Chavel Colin A, Purdon Terence J, Burchett Rebecca, Gillard Bryan M, Brackett Craig M, McGray A J Robert, Bramson Jonathan L, Brentjens Renier J, Lee Kelvin P, Olejniczak Scott H
机构信息
Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
出版信息
bioRxiv. 2024 Apr 9:2024.03.21.586084. doi: 10.1101/2024.03.21.586084.
Recent FDA approvals of chimeric antigen receptor (CAR) T cell therapy for multiple myeloma (MM) have reshaped the therapeutic landscape for this incurable cancer. In pivotal clinical trials B cell maturation antigen (BCMA) targeted, 4-1BB co-stimulated (BBζ) CAR T cells dramatically outperformed standard-of-care chemotherapy, yet most patients experienced MM relapse within two years of therapy, underscoring the need to improve CAR T cell efficacy in MM. We set out to determine if inhibition of MM bone marrow microenvironment (BME) survival signaling could increase sensitivity to CAR T cells. In contrast to expectations, blocking the CD28 MM survival signal with abatacept (CTLA4-Ig) accelerated disease relapse following CAR T therapy in preclinical models, potentially due to blocking CD28 signaling in CAR T cells. Knockout studies confirmed that endogenous CD28 expressed on BBζ CAR T cells drove anti-MM activity. Mechanistically, CD28 reprogrammed mitochondrial metabolism to maintain redox balance and CAR T cell proliferation in the MM BME. Transient CD28 inhibition with abatacept restrained rapid BBζ CAR T cell expansion and limited inflammatory cytokines in the MM BME without significantly affecting long-term survival of treated mice. Overall, data directly demonstrate a need for CD28 signaling for sustained function of CAR T cells and indicate that transient CD28 blockade could reduce cytokine release and associated toxicities.