Type: Oral
Session: 702. CAR-T Cell Therapies: Basic and Translational: Enhancements in CAR-T Cell Signaling, Delivery & Manufacturing
Hematology Disease Topics & Pathways:
Research, Translational Research, Chimeric Antigen Receptor (CAR)-T Cell Therapies, Diseases, Treatment Considerations, Biological therapies, Lymphoid Malignancies, Myeloid Malignancies, Technology and Procedures
Methods: We constructed a system whereby each of two vectors co-expresses a heterodimerizing leucine zipper pair, resulting in affinity-tag expression only on the surface of dual-transduced cells, and enabling selective immunomagnetic purification. Leveraging the increased packaging capacity afforded by the Zip-sort methodology, we co-expressed multiple CARs and switch receptors to enable T cells to overcome antigenic heterogeneity, resist exhaustion, and persist and proliferate in response to inhibitory ligand expression. We also included dual safety switches to enable CAR T cell elimination in case of toxicity. We dual-transduced T cells to express up to four CARs targeting CD19, CD20, CD79b, and BAFF-R and up to three switch receptors including Fas-4-1BB, CD200R-CD27, and PD-1-OX40. We characterized these multi-CAR multi-Switch receptor T cells in vitro with live cell imaging evaluating NFkB signaling, T cell proliferation, and target cell elimination, with single-cell RNA sequencing, and with multiparameter flow cytometry. We also established and tested syngeneic mouse models of pre-B-cell and acute myeloid leukemia with antigen heterogeneity and inhibitory ligand overexpression.
Results: Zip-sort methodology enabled production of highly purified dual-transduced T cells over a range of initial transduction efficiencies without significantly affecting patterns of genomic vector integration compared with single-transduced T cells. Integrated vector copy number was on average two-fold higher in dual-transduced vs. single-transduced T cells. By engineering Zip-sorting technology into safety switches and switch receptors, we further extended the functions of this system while limiting vector insert size. Following single-step Zip-sort purification, dual-transduced T cells expressed multiple CARs and switch receptors with uniformly high purity and receptor expression. These modifications enabled T cells to eliminate heterogeneous leukemia populations expressing up to four target antigens and up to three inhibitory ligands. Dual-CAR T cells targeting CD19 and CD20 and co-expressing Fas-4-1BB, CD200R-CD27, and PD-1-OX40 switch receptors survived and eliminated targets with high FasL expression and proliferated in response to CD200 and PD-L1 expression on leukemia cells. Co-expression of multiple switch receptors reduced transcriptomic signatures of exhaustion in dual-CAR T cells, upregulated gene pathways related to proliferation and metabolic activity, enhanced the capacity of T cells to lyse target cells and release cytokines following repeated antigen challenges, and promoted leukemia clearance in vivo.
Conclusion: Zip-sort purification of dual-transduced T cells facilitates production of complex cell products incorporating multiple transgenic payloads. Our proof of principle experiments demonstrate that T cells can be engineered to overcome multiple tumor resistance mechanisms simultaneously. The Zip-sort system provides a powerful methodology to construct and compare novel cellular therapies and is compatible with clinical translation based on immunomagnetic selection principles.
Disclosures: Boardman: Bristol Myers Squibb: Consultancy; OncLive: Honoraria; Cancer Study Group, LLC: Consultancy. Peled: Crestone Inc: Consultancy; Seres Therapeutics: Patents & Royalties, Research Funding; Prodigy Biosciences: Current equity holder in publicly-traded company, Membership on an entity's Board of Directors or advisory committees; DaVolterra: Consultancy; Canaccord Genuity, Inc: Consultancy; CSL Behring: Consultancy; MaaT Pharma: Consultancy; Postbiotics Plus Research: Current equity holder in publicly-traded company, Membership on an entity's Board of Directors or advisory committees. Klebanoff: Achilles Therapeutics: Consultancy; Affini-T: Consultancy; Aleta BioTherapeutics: Consultancy; Bellicum Pharmaceuticals: Consultancy; Bristol Myers Squibb: Consultancy; Catamaran Bio: Consultancy; Cell Design Labs: Consultancy; Decheng Capital: Consultancy; G1 Therapeutics: Consultancy; Klus Pharma: Consultancy; Obsidian Therapeutics: Consultancy; PACT Pharma: Consultancy; Roche/Genentech: Consultancy; Royalty Pharma: Consultancy; Affini-T Therapeutics: Current equity holder in private company.