Manchon Enzo, Hirt Nell, Versier Benjamin, Soundiramourty Aravindhan, Juricek Ludmila, Lebbe Celeste, Battistella Maxime, Christen Yves, Mallet Jacques, Charron Dominique, Jabrane-Ferrat Nabila, Serguera Che, Al-Daccak Reem
National Institute of Health and Medical Research (INSERM) UMRS-976 HIPI, Paris University, Saint-Louis Hospital, 75010, Paris, France.
Asfalia Biologics, ICM, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
Cell Mol Immunol. 2025 May 8. doi: 10.1038/s41423-025-01290-x.
Despite significant advancements, the effectiveness of chimeric antigen receptor (CAR)-T-cell-based therapies in solid tumors remains limited. Key challenges include on-target effects, off-tumor toxicity and reduced CAR-T-cell function within the tumor microenvironment, which is often characterized by metabolic stress triggered by factors such as amino acid scarcity. Activating transcription factor-4 (ATF4) and its upstream regulator GCN2 play crucial roles in the metabolic reprogramming and functionality of CD4 and CD8 T cells. ATF4 can be activated by various cellular stress signals, including amino acid deprivation. While ATF4 activation may be associated with T-cell dysfunction, its role in stress adaptation presents an opportunity for therapeutic intervention-particularly in the tumor microenvironment, where T-cell exhaustion is a major challenge. In this study, we developed a strategy to harness the GCN2‒ATF4 axis in CAR-T cells. We employed an amino acid-dependent inducible promoter, which triggers ATF4-dependent gene expression to regulate CAR expression in T cells under conditions of amino acid scarcity within the tumor microenvironment. In vitro and murine xenograft models demonstrate the potential of this system to effectively restrict CAR expression to the tumor site. This targeted strategy not only enhances safety by minimizing off-tumor activity but also CAR-T-cell fitness by reducing exhaustion. By validating this pathophysiologically regulatable CAR expression system for solid tumors, our findings address key limitations of current CAR-T-cell therapies and pave the way for innovative strategies targeting solid malignancies.
尽管取得了重大进展,但嵌合抗原受体(CAR)T细胞疗法在实体瘤中的有效性仍然有限。关键挑战包括靶向效应、肿瘤外毒性以及肿瘤微环境中CAR-T细胞功能的降低,肿瘤微环境通常以氨基酸缺乏等因素引发的代谢应激为特征。激活转录因子4(ATF4)及其上游调节因子GCN2在CD4和CD8 T细胞的代谢重编程和功能中发挥着关键作用。ATF4可被包括氨基酸剥夺在内的各种细胞应激信号激活。虽然ATF4的激活可能与T细胞功能障碍有关,但其在应激适应中的作用为治疗干预提供了机会,特别是在肿瘤微环境中,T细胞耗竭是一个主要挑战。在本研究中,我们开发了一种在CAR-T细胞中利用GCN2-ATF4轴的策略。我们采用了一种氨基酸依赖性诱导型启动子,该启动子在肿瘤微环境中氨基酸缺乏的条件下触发ATF4依赖性基因表达,以调节T细胞中的CAR表达。体外和小鼠异种移植模型证明了该系统将CAR表达有效限制在肿瘤部位的潜力。这种靶向策略不仅通过最小化肿瘤外活性提高了安全性,还通过减少耗竭提高了CAR-T细胞的适应性。通过验证这种针对实体瘤的病理生理可调节CAR表达系统我们的研究结果解决了当前CAR-T细胞疗法的关键局限性,并为针对实体恶性肿瘤的创新策略铺平了道路。