Decade-long leukemia remissions with persistence of CD4+ CAR T-cells
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ABSTRACT:
PROVIDER: PRJNA841739 | ENA |
REPOSITORIES: ENA
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Project description:Decade-long leukemia remissions with persistence of CD4+ CAR T-cells
| PRJNA841740 | ENA
Project description:The adoptive transfer of T lymphocytes reprogrammed to target tumour cells has demonstrated potential for treatment of various cancers1-7. However, little is known about the long-term potential and clonal stability of the infused cells. Here we studied long-lasting CD19-redirected chimeric antigen receptor (CAR) T cells in two patients with chronic lymphocytic leukaemia1-4 who achieved a complete remission in 2010. CAR T cells remained detectable more than ten years after infusion, with sustained remission in both patients. Notably, a highly activated CD4+ population emerged in both patients, dominating the CAR T cell population at the later time points. This transition was reflected in the stabilization of the clonal make-up of CAR T cells with a repertoire dominated by a small number of clones. Single-cell profiling demonstrated that these long-persisting CD4+ CAR T cells exhibited cytotoxic characteristics along with ongoing functional activation and proliferation. In addition, longitudinal profiling revealed a population of gamma delta CAR T cells that prominently expanded in one patient concomitant with CD8+ CAR T cells during the initial response phase. Our identification and characterization of these unexpected CAR T cell populations provide novel insight into the CAR T cell characteristics associated with anti-cancer response and long-term remission in leukaemia.
| S-EPMC9166916 | biostudies-literature
Project description:Chimeric antigen receptor–T (CAR-T) cell therapies can eliminate relapsed and refractory tumors, but the durability of antitumor activity requires in vivo persistence. Differential signaling through the CAR costimulatory domain can alter the T cell metabolism, memory differentiation, and influence long-term persistence. CAR-T cells costimulated with 4-1BB or ICOS persist in xenograft models but those constructed with CD28 exhibit rapid clearance. Here, we show that a single amino acid residue in CD28 drove T cell exhaustion and hindered the persistence of CD28-based CAR-T cells and changing this asparagine to phenylalanine (CD28-YMFM) promoted durable antitumor control. In addition, CD28-YMFM CAR-T cells exhibited reduced T cell differentiation and exhaustion as well as increased skewing toward Th17 cells. Reciprocal modification of ICOS-containing CAR-T cells abolished in vivo persistence and antitumor activity. This finding suggests modifications to the costimulatory domains of CAR-T cells can enable longer persistence and thereby improve antitumor response.
2020-02-11 | GSE145007 | GEO
Project description:The aim of the study was to compare and contrast cytokine production by CD4+ chimeric antigen receptor + T-cells and putative myeloid derived suppressor cell populations (CD11b+Gr-1 hi and lo) in the spleens of Balb/c mice which had received a transfer of CD19 specific second-generation CAR T-cells 56 days previously following cyclophosphamide pre-conditioning. Splenocytes from four individual mice were pooled, incubated with antibodies to CD4, CD34 (CAR), CD11b, Gr-1 and sorted using flow cytometric cell sorting for CD4+CD34+, Gr-1 and the negative cell fraction. Total RNA was isolated and samples loaded in duplicate in the array. Data was normalized to global expression levels.
2014-02-06 | E-GEOD-54696 | biostudies-arrayexpress
Project description:Chimeric antigen receptor (CAR) T-cells induce responses in patients with relapsed/refractory leukemia; however, long-term efficacy is frequently limited by post-CAR relapses. The inability to target antigen-low cells is an intrinsic vulnerability of second-generation CAR T-cells and underlies the majority of relapses following CD22BBz CAR T-cell therapy. We interrogated CD22BBz CAR signaling in response to low antigen and found inefficient phosphorylation of LAT, limiting downstream signaling. To overcome this, we designed the Adjunctive LAT-Activating CAR T-cell (ALA-CART) platform, pairing a second-generation CAR with a LAT-CAR incorporating the intracellular domain of LAT. ALA-CART cells demonstrated reduced differentiation during manufacturing and increased LAT phosphorylation, MAPK signaling and AP-1 activity. Consequently, ALA-CART cells showed improved cytotoxicity, proliferation, persistence and efficacy against antigen-low leukemias that were refractory to clinically-active CD22BBz CAR T-cells. These data suggest restoration of LAT signaling through the ALA-CART platform represents a promising strategy for overcoming multiple mechanisms of CAR T-cell failure.
2025-05-02 | PXD058699 | Pride
Project description:Multiple myeloma is characterized by frequent clinical relapses following conventional therapy. Recently, chimeric antigen receptor T (CAR-T) cells targeting B-cell maturation antigen (BCMA) has been established as a treatment for patients with relapsed or refractory disease. However, while >70% of patients initially respond to this treatment, clinical relapse and disease progression occurs in most cases. Recent studies showed persistent expression of BCMA at the time of relapse, indicating that immune intrinsic mechanisms may contribute to this resistance. While there were no pre-existing T cell features associated with clinical outcomes, we found that patients with a durable response to CAR-T cell treatment had greater persistence of their CAR-T cells compared to patients with transient clinical responses. They also possessed a significantly higher proportion of CD8+ T effector memory cells. In contrast, patients with short-lived responses to treatment have increased frequencies of cytotoxic CD4+ CAR-T cells. These cells expand in vivo early after infusion but express exhaustion markers (HAVCR2 and TIGIT) and remain polyclonal. Finally, we demonstrate that non-classical monocytes are enriched in the myeloma niche and may induce CAR-T cell dysfunction through mechanisms that include TGFβ. These findings shed new light on the role of cytotoxic CD4+ T cells in disease progression after CAR-T cell therapy.
2024-07-29 | GSE246342 | GEO
Project description:Multiple myeloma is characterized by frequent clinical relapses following conventional therapy. Recently, chimeric antigen receptor T (CAR-T) cells targeting B-cell maturation antigen (BCMA) has been established as a treatment for patients with relapsed or refractory disease. However, while >70% of patients initially respond to this treatment, clinical relapse and disease progression occurs in most cases. Recent studies showed persistent expression of BCMA at the time of relapse, indicating that immune intrinsic mechanisms may contribute to this resistance. While there were no pre-existing T cell features associated with clinical outcomes, we found that patients with a durable response to CAR-T cell treatment had greater persistence of their CAR-T cells compared to patients with transient clinical responses. They also possessed a significantly higher proportion of CD8+ T effector memory cells. In contrast, patients with short-lived responses to treatment have increased frequencies of cytotoxic CD4+ CAR-T cells. These cells expand in vivo early after infusion but express exhaustion markers (HAVCR2 and TIGIT) and remain polyclonal. Finally, we demonstrate that non-classical monocytes are enriched in the myeloma niche and may induce CAR-T cell dysfunction through mechanisms that include TGFβ. These findings shed new light on the role of cytotoxic CD4+ T cells in disease progression after CAR-T cell therapy.
2024-08-07 | GSE274185 | GEO
Project description:transcriptional profiling was performed on Regnase-1 KO CAR and Regnase-1 TCF-1 DKO CAR T cells isolated 7days after co-transfer into tumor bearing mice. TCF-1 deficiency in Regnase-1 KO CAR T cells led to reduced long-term persistence and memory-like phenotype.
2021-04-07 | GSE155020 | GEO
Project description:Chimeric antigen receptor (CAR) T cell therapy marks a significant advancement in oncology, offering the promise of durable remissions in hematological malignancies. However, solid tumors present formidable challenges, including on-target off-tumor toxicity, exhaustion, and limited persistence of therapeutic T cells. Here, we engineered sonogenetic EchoBack-CAR T cells using a highly heat-sensitive promoter, evolved through a sort-seq platform, and integrated it with a positive feedback loop from CAR signaling pathways that enables the conversion of tumor engagement into CAR production, resulting in long-lasting CAR expression upon remote stimulation by focused ultrasound (FUS). EchoBack-CAR T cells with a high-affinity single-chain variable fragment (scFv) targeting disialoganglioside GD2 (EchoBack-hGD2CAR) exhibited potent cytotoxicity and persistence in an in vitro glioblastoma spheroid model. In both subcutaneous and orthotopic glioblastoma models in mice, EchoBack-hGD2CAR T cells achieved robust and safe tumor suppression without off-tumor toxicity. Through single-cell RNA sequencing, we uncovered a distinctive transcriptomic landscape that underscores the enhanced cytotoxicity and reduced exhaustion of EchoBack-CAR T cells after chronic antigen stimulation compared to standard CAR T cells that constitutively express CAR. The EchoBack-CAR can also be generalized and extended to treat prostate cancer by targeting prostate-specific membrane antigen (EchoBack-PSMACAR), demonstrating a remarkable tumor suppression but minimal off-tumor toxicity to healthy tissues. Collectively, these findings not only highlight the potential of EchoBack-CAR T cells to promote solid tumor immunotherapy via ultrasound remote control but also present a modular approach adaptable to various cancer targets, poised to mitigate the limitations of current CAR T cell therapies.
2025-05-29 | GSE289368 | GEO
Project description:The underpinning mechanisms driving chimeric antigen receptor (CAR) T cell function and persistence after infusion, and their correlation with clinical outcome, remains poorly understood. Here, we applied single-cell multiomics, coupled with gene regulatory network analyses, to evaluate CAR-T cell transcriptional heterogeneity, dynamics and clonal evolution, in longitudinal bone marrow (BM) and peripheral blood (PB) paired samples, collected from MM patients treated with BCMA CAR T cells. We identify several regulons with increased activity, within CAR T cell infiltrating the BM, as key drivers of the more activated and exhausted phenotype observed in those cells compared to their PB counterparts. Interestingly, regulatory dysfunctions in the effector-to-memory axis promoted higher presence of terminally differentiated cells, leading to a lack of CAR T cell persistence. Moreover, we identified a hyperexpanded CAR T clone in the BM of a patient with partial response. Deeper characterization showed increased IL10 expression in that clone, that was associated to transcription factors related to exhausted CAR T cells, like PRDM1. Overall, our analyses provide insights into the regulatory mechanisms that could promote lack of CAR T cell persistence and dysfunction, representing potential targets to be modulated for the development of improved CAR T therapies for MM.
2026-03-04 | GSE290061 | GEO