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4817 Advances in CD137-Enriched Adoptive T Cell Therapy for Acute Myeloid Leukemia Via Ex Vivo Immune Cell Priming with DC/AML Fusion Vaccine

Program: Oral and Poster Abstracts
Session: 703. Cellular Immunotherapies other than CAR-T Cells: Basic and Translational: Poster III
Hematology Disease Topics & Pathways:
Research, Translational Research
Monday, December 9, 2024, 6:00 PM-8:00 PM

Kathrine S Rallis, MBBS, MSc1, Jessica Liegel, MD2, Giulia Cheloni, PhD3*, Poorva Bindal, MD2, Isabella Saldarriaga, BS3*, Junyan Zhang2*, Georges Chedid, MD2*, Joseph Abirached, BS2*, Jonah Lee, BS2*, John G. Clohessy, PhD2*, Samprity Ankita, BS2*, Rajeev Relangi, BS2*, Lina Bisharat, MS2*, Hazal Toros, MS2*, Sophia Adamia, PhD2, Jasper B Lee, AB4*, Donald Kufe, MD4*, Kai W Wucherpfennig, MD, PhD4*, Jacalyn Rosenblatt, MD3 and David Avigan, MD3

1Beth Israel Deaconess Medical Center, Harvard Medical School, Brookline, MA
2Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
3Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
4Dana Farber Cancer Institute, Harvard Medical School, Boston, MA

Background: We have pioneered a vaccine by fusion of patient-derived tumor with autologous dendritic cells (DCs) that presents an array of tumor antigens generating a polyclonal immune response. In a phase II clinical trial, DC/AML vaccination led to expansion of leukemia-specific T cells with durable disease remission. Ex vivo generation of vaccine-educated T cells (VETc) is a potent approach for adoptive cell therapy that selectively captures tumor heterogeneity. In murine AML and MM models, enrichment of VETc for activated antigen-specific effector cells via agonistic CD137 antibody-based selection further enhances for cytotoxicity, T cell activation and memory phenotype (Rallis et al., Blood (2023) 142, Supplement 1). Here, we report updates for CD137+ VETc in murine models, findings for CD137+ VETc in primary human AML cells, and validation of TGF-β signaling inhibition in VETc via SMAD2 knockout to counter immunosuppression.

Methods: DC/AML vaccines were generated by fusing C57BL/6J mice DCs and syngeneic C1498 mCherry/luciferase+ AML cells or primary human DCs and patient derived AML cells. Splenic murine T cells or human T cells isolated from peripheral blood were co-cultured with autologous irradiated DC/AML fusions in presence of IL-2/7/15. Selection with biotinylated agonistic CD137 antibody was performed on VETc followed by expansion and activation via CD3/CD28. T cells were phenotyped for activation (CD25/CD69), immune checkpoints (PD1/LAG3/TIM3) and memory (CD44+CD62L- or CCR7+CD45RA-). Cytotoxicity was evaluated by luminescence. Mice inoculated with C1498 and injected with T cells after 7 days were imaged by BLI and monitored for survival. Human tumor reactive T (TRT) cells were enriched for CD137 and expanded in a closed system using the CliniMACS Prodigy instrument (Miltenyi). CRISPR-Cas9 ribonucleoproteins (RNPs) were generated by incubating three SMAD2 sgRNAs (Synthego) with Cas9 protein (Macrolabs, UC Berkeley) in nuclease-free duplex buffer (IDT). The effect of TGF-β on cell proliferation was assessed on human VETc electroporated in the presence [SMAD2 knockout (KO)] or absence [SMAD2 wildtype (WT)] of RNPs and cultured in the presence or absence of TGF-β (50 ng/mL). Cells were stained with Cell Trace Violet dye (Thermo Fisher) and allowed to proliferate in culture for 5 days.

Results: In the C1498 model, VETc selected based on CD137 expression demonstrate enhanced immune activation (CD25+CD69+) and memory (CD44+CD62L-) phenotype compared to unstimulated naïve T-cell controls (TN) (9.3-fold, p=0.0009; 4.4-fold, p=0.0013, respectively). The CD137+ VETc showed 11.2-fold enhanced cytotoxicity compared to TN at 10:1 E:T (p<0.0001), while VETc showed 44-fold increase (p=0.0020). Anti-tumor activity and specificity was maintained following CD3/CD28-mediated expansion. In vivo, a survival benefit was observed for mice treated with CD137+ VETc (100 days mOS not reached, p=0.0082) and VETc (mOS=39 days, p=0.0082) compared to mice treated with TN (mOS=28 days). In the human model, CD137+ VETc demonstrate enhanced immune activation compared to TN (15.8-fold, p=0.0060). A 16-fold target cell expansion was observed across 10 days with a cell viability of 85-100% in the CliniMACS Prodigy. SMAD2 KO resulted in indel efficiency of 100% and predicted KO score of 99% calculated by synthego inference of CRISPR edits analysis. Western blot validation confirmed significant reduction in SMAD2 protein levels in KO cells, with near complete loss of protein expression. SMAD2 KO T cells exhibited increased proliferation in culture media containing TGF-β compared to WT.

Conclusion: VETc enriched for CD137 via agonistic antibody selection represents a unique approach for adoptive immunotherapy in AML with enhanced cytotoxicity, activation, and memory cell phenotype. We report a first institutional experience using a closed system to manufacture TRT cells as an adoptive cell therapy for patients with AML. Knockout of SMAD2 was validated in human T cells as a strategy to mitigate cytostasis by immunosuppressive TGF-β signaling. Ongoing investigations are evaluating the effects of lymphodepletion and immune boosting with DC/AML vaccination on T cell persistence and expansion in vivo using a C57BL/6-CD45.1/2 immunocompetent murine model for adoptive T cell tracking. Future directions include clinical trial investigation of the proposed cellular therapy in AML patients.

Disclosures: Liegel: Janssen: Research Funding; Beth Israel Deaconess Medical Center: Current Employment; Novartis: Research Funding; Seagen: Research Funding. Abirached: Alexion Pharmaceuticals: Current Employment; Moderna: Ended employment in the past 24 months. Wucherpfennig: DEM BioPharma: Membership on an entity's Board of Directors or advisory committees; Solu Therapeutics: Membership on an entity's Board of Directors or advisory committees; D2M Biotherapeutics: Membership on an entity's Board of Directors or advisory committees; Nextechinvest: Membership on an entity's Board of Directors or advisory committees; Immunitas Therapeutics: Other: Co-founder; Novartis: Research Funding; Fate Therapeutics: Research Funding; TScan therapeutics: Current equity holder in publicly-traded company. Rosenblatt: Bristol myers squibb: Research Funding; Parexel/Calyx: Consultancy, Other: blinded adjudicator for clinical trial data; Clario (BioClinica): Consultancy, Other: blinded adjudicator for clinical trial data; Sanofi: Research Funding; Janssen Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; USPTO: Patents & Royalties: US patent no. 11, 026,921, ; KITE: Membership on an entity's Board of Directors or advisory committees; Attivare therapeutics: Consultancy; Karyopham therapeutics: Other: DSMB. Avigan: Pharmacyclics: Research Funding; Celgene: Consultancy, Other: Advisory Role, Research Funding; Partners Therapeutics: Consultancy, Other: Advisory Board; Sanofi: Consultancy, Other: Advisory Board; Karyopharm Therapeutics: Consultancy, Other: Advisory Role; Kite, a Gilead Company: Research Funding; Chugai Pharma: Consultancy, Other: Advisory Role; Kite/Gilead: Consultancy, Other: Advisory Role, Research Funding; Legend Biotech: Consultancy, Other: Advisory Role; Juno Therapeutics: Consultancy, Other: Advisory Role; Takeda: Consultancy, Other: Advisory Role; Janssen: Consultancy, Other: Advisory Board; Kowa Pharmaceutical: Consultancy, Other: Advisory Board; Paraxel: Current Employment; Aviv Med Tech: Consultancy, Other: Advisory Board; Bristol Myers Squibb: Consultancy, Other: Advisory Board.

*signifies non-member of ASH