1. Off-the-shelf, steroid-resistant, IL13Rα2-specific CAR T cells for treatment of glioblastoma
- Author
-
Brown, Christine E, Rodriguez, Analiz, Palmer, Joycelynne, Ostberg, Julie R, Naranjo, Araceli, Wagner, Jamie R, Aguilar, Brenda, Starr, Renate, Weng, Lihong, Synold, Timothy W, Tran, Vivi, Wang, Shelley, Reik, Andreas, D’Apuzzo, Massimo, Ressler, Julie A, Zhou, Yuanyue, Mendel, Matthew, Gregory, Philip D, Holmes, Michael C, Tang, Winson W, Forman, Stephen J, Jensen, Michael C, and Badie, Behnam
- Subjects
Cancer Research ,Oncology ,T-Lymphocytes ,Clinical Investigations ,Interleukin-13 Receptor alpha2 Subunit ,Humans ,Steroids ,Neurology (clinical) ,Glioblastoma ,Glucocorticoids ,Immunotherapy, Adoptive ,Xenograft Model Antitumor Assays ,Dexamethasone - Abstract
Background Wide-spread application of chimeric antigen receptor (CAR) T cell therapy for cancer is limited by the current use of autologous CAR T cells necessitating the manufacture of individualized therapeutic products for each patient. To address this challenge, we have generated an off-the-shelf, allogeneic CAR T cell product for the treatment of glioblastoma (GBM), and present here the feasibility, safety, and therapeutic potential of this approach. Methods We generated for clinical use a healthy-donor derived IL13Rα2-targeted CAR+ (IL13-zetakine+) cytolytic T-lymphocyte (CTL) product genetically engineered using zinc finger nucleases (ZFNs) to permanently disrupt the glucocorticoid receptor (GR) (GRm13Z40-2) and endow resistance to glucocorticoid treatment. In a phase I safety and feasibility trial we evaluated these allogeneic GRm13Z40-2 T cells in combination with intracranial administration of recombinant human IL-2 (rhIL-2; aldesleukin) in six patients with unresectable recurrent GBM that were maintained on systemic dexamethasone (4-12 mg/day). Results The GRm13Z40-2 product displayed dexamethasone-resistant effector activity without evidence for in vitro alloreactivity. Intracranial administration of GRm13Z40-2 in four doses of 108 cells over a two-week period with aldesleukin (9 infusions ranging from 2500–5000 IU) was well tolerated, with indications of transient tumor reduction and/or tumor necrosis at the site of T cell infusion in four of the six treated research subjects. Antibody reactivity against GRm13Z40-2 cells was detected in the serum of only one of the four tested subjects. Conclusions This first-in-human experience establishes a foundation for future adoptive therapy studies using off-the-shelf, zinc-finger modified, and/or glucocorticoid resistant CAR T cells.
- Published
- 2022
- Full Text
- View/download PDF