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4849 Cord Blood-Derived Carcik Cells As Off-the-Shelf Non-Viral Cell Therapy for Hematological Malignancies

Program: Oral and Poster Abstracts
Session: 711. Cell Collection and Manufacturing of HSPCs, CAR-T Cells, and Other Cellular Therapy Products: Poster III
Hematology Disease Topics & Pathways:
Research, Translational Research, Chimeric Antigen Receptor (CAR)-T Cell Therapies, Cell expansion, Treatment Considerations, Biological therapies, Technology and Procedures
Monday, December 9, 2024, 6:00 PM-8:00 PM

Ilaria Pisani1*, Giusi Melita1*, Simone Naso1*, Michele Francesco Quaroni2*, Giada Matera2*, Daniela Belotti2*, Benedetta Cabiati2*, Elisa Gotti3*, Carolina Cuofano3*, Chiara Capelli3*, Jolanda Sarno1*, Angela Maria Savino4*, Ilaria Ratti5*, Daniele Prati5*, Benedetta Rambaldi6*, Giorgio Ottaviano7*, Giovanna Lucchini7*, Giuseppe Dastoli1*, Andrea Biondi1,8, Alessandro Rambaldi9, Josee Golay3*, Martino Introna3*, Giuseppe Gaipa1,2 and Sarah Tettamanti, PhD1*

1Tettamanti Center, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
2Laboratorio di Terapia Cellulare e Genica Stefano Verri, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
3Centro di Terapia Cellulare "G. Lanzani", Bergamo, Italy
4Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
5Department of Transfusion Medicine and Hematology, Milano Cord Blood Bank, Processing Facility and Biobank POLI-MI, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
6Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
7Department of Pediatrics, Bone Marrow Transplant Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
8Pediatrics Department, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
9Department of Oncology and Hematology, University of Milan and ASST Papa Giovanni XXIII, Bergamo, Italy

Commercial CAR T cells typically employ autologous T cells, which can be functionally unfit due to patient age, prior treatments, and tolerance within the tumor microenvironment. The autologous approach has practical drawbacks too, including manufacturing failures, time-consuming production, and high costs, prompting the need for more feasible and efficient protocols. Efforts are now focused on developing allogeneic CAR T cell therapies, though challenges like Graft-Versus-Host Disease (GVHD) and limited persistence remain. Our work has proven feasibility and safety of using Peripheral Blood (PB) healthy donor cells to generate CARCIK-CD19 cells1. Cord blood (CB) is a standard hematopoietic stem cell source and offers immunological advantages such as reduced risk of GVHD2 and enhanced graft versus leukemia particularly in patients with pre-transplant residual disease. CB T cells exhibit greater proliferation compared to adult PB T cells, especially when stimulated with cytokines like IL-7 and IL-152. Cytokine-induced killer (CIK) cells, which are CD3+CD56+-enriched T cells, are easily expandable in vitro from PBMCs and are associated with minimal GVHD. CIK cells, similar to natural killer cells, possess non-MHC-restricted cytolytic activity and have proven to be safe and effective against various solid and hematologic malignancies, representing an alternative effector T cell source for adoptive immunotherapy3. We demonstrated that functional CIK cells can be derived from both fresh and cryopreserved CB units4,5. The CB rapid availability and the low risk of GvHD represent appealing features for the generation of banked third-party “off the shelf” CB-derived CARCIK cells.

Fresh or thawed CB mononuclear cells were successfully modified with a third generation anti-CD19.CAR using a non-viral Sleeping Beauty (SB) transposon gene transfer platform optimized by our group, reaching up to 50% of CAR expression. Compared to the protocol for PB-derived CARCIK cells, we added a purification step to remove erythroblasts and used IL-7 and IL-15 instead of IL-2. These two variables significantly increased the cell yields of CARCIK cells obtained from frozen CB bags (from 5x108 to 1.6x109 total cells/CB bag subunit). Interestingly, we observed that CB-derived CARCIK cells are more metabolically fit. Using the NanoString CAR T Characterization Panel, we found differential gene expression profiles between PB and CB-derived CARCIK-CD19 cells. CB-derived cells exhibited a lower glycolysis score, validated by Seahorse analysis, and enhanced patterns of persistence, chemokine signaling, and T-cell migration. The in vitro functional profile of CB-derived CARCIK-CD19 was comparable to PB-derived ones. We then conducted three large-scale good manufacturing Practices (GMP)-grade validation runs using frozen CB bags. The total cell yields and CAR expression were 1.83 x 1010, 2 x 1010 and 2.5 x109 and 62.3%, 36.42% and 10.0% for the three respective runs. GMP-grade runs of both CB- and PB- derived CARCIKCD19 cells were functionally validated in vivo using a DAUDI xenograft NSG model, where both cell products prolonged the survival of treated mice and controlled disease progression. We are currently planning to incorporate these findings in our upcoming clinical studies with CARCIK cells.

In conclusion, we have successfully demonstrated the feasibility of deriving functional CARCIK-CD19 cells from the cord blood (CB) source. Metabolic and transcriptomic analyses revealed that CB-CARCIK cells exhibit a lower glycolytic score and a higher memory score compared to those derived from peripheral blood (PB), indicating advantageous CAR T cell characteristics. Furthermore, we established the scalability of a GMP-grade manufacturing process for deriving CARCIK cells from CB, enabling the production of readily available, banked, third-party CARCIK cells for treating hematological malignancies.

References:

1 Magnani CF, et al. J Clin Invest 2020; 130: 6021–6033.

2 Borrill R, et al. Front Pediatr 2023; 11: 1232281.

3 Schmeel LC, et al. J Cancer Res Clin Oncol 2015; 141: 839–49.

4 Introna M, et al. Bone Marrow Transplant 2006; 38. doi:10.1038/sj.bmt.1705503.

5 Introna M, et al. Biology of Blood and Marrow Transplantation 2010. doi:10.1016/j.bbmt.2010.05.015.

Disclosures: Biondi: CoImmune, Galapagos, Amgen, Novartis, BMS: Consultancy, Research Funding, Speakers Bureau. Rambaldi: Astellas: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Speakers Bureau; Jazz: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Speakers Bureau; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Speakers Bureau; Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Speakers Bureau; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Speakers Bureau; Incyte: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Speakers Bureau; Kite-Gilead: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Speakers Bureau; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Speakers Bureau; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Speakers Bureau; Omeros: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Speakers Bureau.

*signifies non-member of ASH