A New Method Produces CAR-T Cells to Keep Fighting Disease Longer
Strategy May Bolster Blood Cancer Therapy and Move HIV Research Closer to a Cure
"Our goal was to engineer therapeutic immune cells so they would not only be powerful killers but also long-lived and capable of self-renewal, to markedly extend their effectiveness after infusion into patients," said senior author
The CAR-T Durability Challenge
To turbocharge disease-specific immune responses in patients, CAR-T cells are produced by removing a person's immune T cells and inserting genes that reprogram them to act as guided missiles to recognize and selectively eliminate cancer cells or virus-infected cells. After being generated in the laboratory, the engineered CAR-T cells are infused back into patients, where they seek out and eliminate the targeted malignant or infected cells. However, the long-term efficacy of this therapy has been limited by a major obstacle. Although CAR-T therapy can initially produce dramatic remissions, its killing ability often diminishes over time. In roughly half of treated cancer patients, as the activity of the CAR-T cells dwindles, the cancer returns.
The same persistence problem has constrained efforts to extend CAR-T therapy to treat people living with HIV. Current antiretroviral drugs (ART) can suppress HIV production to undetectable levels but cannot eliminate immune cells already infected with HIV. If this treatment is stopped, the virus hidden inside immune cells in long-lived, dormant HIV reservoirs reawakens to restore widespread infection. As a result, people living with HIV must take ART for life, which can lead to metabolic, neurological, cardiovascular, and other side effects.
Needed: A
To achieve a functional cure for cancer and HIV using CAR-T cells, the engineered cells would need to patrol the body for years, continually hunting down and eliminating residual malignant or infected cells, a level of long-term functional persistence not yet achievable using current manufacturing methods. To overcome this drawback,
The multi-cytokine scaffold-produced CAR-T cells retained strong disease-fighting abilities. Most importantly, more than half of these CAR-T cells belong to a rare population known as T memory stem cells, long-lived cells that are capable of self-renewal and of generating fresh waves of highly active immune fighters over time. By contrast, less than 5% of CAR-T cells produced using the conventional method displayed this long-lived, stem cell-like profile.
"T memory stem cells are considered to be critical for long-term immune persistence," said
A More Persistent Response
In a mouse model of human leukemia, both conventional and multi-cytokine scaffold-generated CAR-T cells eliminated human cancer cells after the initial treatment. But a few weeks later, when the researchers simulated cancer relapse by re-infusing these leukemia cells into the mice, only the multi-cytokine scaffold-engineered CAR-T cells mounted a strong "recall" response, expanding in number again and preventing tumor recurrence.
In a humanized mouse model of HIV infection, the multi-cytokine scaffold-generated CAR-T cells exhibited enhanced antiviral potency by eliminating significantly more HIV-infected cells than conventionally manufactured CAR-T cells. In addition, CAR-T cells generated from patients living with HIV using the new multi-cytokine scaffold production technique successfully eradicated HIV-infected cells.
The findings from this research could have important implications across the CAR-T cell field. "Now that we have shown that we can generate potent CAR-T cells that are longer-lived, we may be able to reduce blood cancer relapse rates and improve long-term remission for cancer patients,"
Additional Einstein authors include
The title of the paper is "IL-7/IL-15/IL-21 cytokine-fusion scaffold generates highly functional CAR-T cells enriched in long-lived T memory stem cells." Funding sources include the National Institutes of Health: R01AI172607, R01AI174275, P30 AI124414, T32AI007501, R01CA263079, UL1TR001866.
About Albert Einstein College of Medicine
Albert Einstein College of Medicine is one of the nation's premier academic centers for basic science research, clinical investigation, and biomedical education. Located in the
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SOURCE Albert Einstein College of Medicine
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