Sensitive and adaptable pharmacological control of CAR T cells through extracellular receptor dimerization

JCI Insight. 2019 Apr 30;5(11):e124430. doi: 10.1172/jci.insight.124430.

Abstract

Chimeric antigen receptor (CAR) T cell therapies have achieved promising outcomes in several cancers, however more challenging oncology indications may necessitate advanced antigen receptor designs and functions. Here we describe a bipartite receptor system comprised of separate antigen targeting and signal transduction polypeptides, each containing an extracellular dimerization domain. We demonstrate that T cell activation remains antigen dependent but can only be achieved in the presence of a dimerizing drug, rapamycin. Studies performed in vitro and in xenograft mouse models illustrate equivalent to superior anti-tumor potency compared to currently used CAR designs, and at rapamycin concentrations well below immunosuppressive levels. We further show that the extracellular positioning of the dimerization domains enables the administration of recombinant re-targeting modules, potentially extending antigen targeting. Overall, this novel regulatable CAR design has exquisite drug sensitivity, provides robust anti-tumor responses, and is uniquely flexible for multiplex antigen targeting or retargeting, which may further assist the development of safe, potent and durable T cell therapeutics.

Keywords: Cancer immunotherapy; Gene therapy; Leukemias; Oncology; Therapeutics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antigens, CD19 / immunology*
  • Antigens, CD19 / metabolism
  • Cell Line, Tumor
  • Female
  • Humans
  • Immunotherapy, Adoptive / methods*
  • Lymphocyte Activation
  • Mice
  • Neoplasms / immunology
  • Neoplasms / pathology
  • Neoplasms / therapy*
  • Promoter Regions, Genetic / drug effects
  • Promoter Regions, Genetic / genetics
  • Protein Domains / genetics
  • Protein Multimerization / drug effects
  • Protein Multimerization / genetics
  • Receptors, Chimeric Antigen / genetics*
  • Receptors, Chimeric Antigen / immunology
  • Receptors, Chimeric Antigen / metabolism
  • Recombinant Fusion Proteins / genetics*
  • Recombinant Fusion Proteins / immunology
  • Recombinant Fusion Proteins / metabolism
  • Single-Chain Antibodies / genetics
  • Single-Chain Antibodies / immunology
  • Single-Chain Antibodies / metabolism
  • Sirolimus / administration & dosage
  • T-Lymphocytes / immunology
  • T-Lymphocytes / metabolism
  • T-Lymphocytes / transplantation
  • Xenograft Model Antitumor Assays

Substances

  • Antigens, CD19
  • CD19 molecule, human
  • Receptors, Chimeric Antigen
  • Recombinant Fusion Proteins
  • Single-Chain Antibodies
  • Sirolimus