Preventing Lck Activation in CAR T Cells Confers Treg Resistance but Requires 4-1BB Signaling for Them to Persist and Treat Solid Tumors in Nonlymphodepleted Hosts.

Abstract

PURPOSE:

Chimeric antigen receptor (CAR) T cells have shown promise against solid tumors, but their efficacy has been limited, due in part, to immunosuppression by CD4+FoxP3+ regulatory T cells (Tregs). Although lymphodepletion is commonly used to deplete Tregs, these regimens are nonspecific, toxic, and provide only a narrow window before Tregs repopulate hosts. Importantly, CARs have also been shown to inadvertently potentiate Tregs by providing a source of IL2 for Treg consumption. We explored whether disruption of the IL2 axis would confer efficacy against solid tumors without the need for lymphodepletion.

EXPERIMENTAL DESIGN:

We developed second- (CD28z) and third- (CD28-4-1BBz) generation CARs targeting EGFRvIII. To eliminate secretion of IL2, 2 amino acid substitutions were introduced in the PYAP Lck-binding motif of the CD28 domain (ΔCD28). We evaluated CARs against B16 melanomas expressing EGFRvIII.

RESULTS:

CD28z CARs failed to engraft in vivo. Although 4-1BB addition improved expansion, CD28-4-1BBz CARs required lymphodepletion to treat solid tumors. CARs deficient in Lck signaling, however, significantly retarded tumor growth without a need for lymphodepletion and this was dependent on inclusion of 4-1BB. To evaluate CAR vulnerability to Tregs, we lymphodepleted mice and transferred CARs alone or with purified Tregs. Cotransfer with Tregs abrogated the efficacy of CD28-4-1BBz CARs, whereas the efficacy of ΔCD28-4-1BBz CARs remained unperturbed.

CONCLUSIONS:

In the absence of lymphodepletion, CARs targeting solid tumors are hindered by Treg immunosuppression and poor persistence. Here, CARs were modified to circumvent Treg suppression and to simultaneously improve in vivo engraftment. Modified CARs treated solid tumors without a need for lymphodepletion.

• Authors: Carter M Suryadevara, Rupen Desai, S Harrison Farber, Bryan D Choi, Adam M Swartz, Steven H Shen, Patrick C Gedeon, David J Snyder, James E Herndon 2nd, Patrick Healy, Elizabeth A Reap, Gary E Archer, Peter E Fecci, John H Sampson, Luis Sanchez-Perez
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 25 Issue 1 Pg. 358-368 (01 01 2019) ISSN: 1557-3265 [Electronic] United States
• PMID: 30425092 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: ©2018 American Association for Cancer Research.

Chemical References

• CD28 Antigens
• IL2 protein, human
• Interleukin-2
• Receptors, Chimeric Antigen
• TNFRSF9 protein, human
• Tumor Necrosis Factor Receptor Superfamily, Member 9

Topics

• Animals
• CD28 Antigens (genetics, immunology)
• Heterografts
• Humans
• Immunotherapy, Adoptive
• Interleukin-2 (genetics, immunology)
• Mice
• Neoplasms (immunology, pathology, therapy)
• Receptors, Chimeric Antigen (immunology, therapeutic use)
• Signal Transduction
• T-Lymphocytes, Regulatory (immunology, pathology)
• Tumor Necrosis Factor Receptor Superfamily, Member 9 (genetics, immunology)