B-ALL GPR65 expression influences susceptibility to CAR-T therapy through a VEGF and macrophage-dependent mechanism [bulk RNA-Seq]
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ABSTRACT: Chimeric antigen receptor (CAR)-T cell therapy has shown promise in treating CD19+ hematological tumors, but some patients fail to respond. Here we used an immune-competent mouse model of B cell acute lymphoblastic leukemia (B-ALL) to assess clonal tumor populations with distinct responses to CAR-T cell therapy. We identified GPR65 as a determinant of tumor responsiveness to CAR-T cell therapy, with high GPR65 expression associated with a complete response. GPR65 KO tumors were resistant to CAR-T treatment in vivo. This was associated with increased tumor VEGFA expression driven by FOXO1 activation and expanded host macrophages. Either depletion of host macrophages or deletion of VEGFA from GPR65 KO tumors restored responsiveness to CAR-T cell treatment. Anti-VEGFa therapy, in combination with CD19-CAR-T, prolongs the survival of GPR65-KO tumor-bearing mice in pre-clinical models. Our results indicate that GPR65 may be a useful biomarker for tumor responsiveness to CAR-T cell therapy and further suggest VEGFA or host macrophages as therapeutic targets to improve CAR-T efficacy.
Project description:Chimeric antigen receptor (CAR)-T cell therapy has shown promise in treating CD19+ hematological tumors, but some patients fail to respond. Here we used an immune-competent mouse model of B cell acute lymphoblastic leukemia (B-ALL) to assess clonal tumor populations with distinct responses to CAR-T cell therapy. We identified GPR65 as a determinant of tumor responsiveness to CAR-T cell therapy, with high GPR65 expression associated with a complete response. GPR65 KO tumors were resistant to CAR-T treatment in vivo. This was associated with increased tumor VEGFA expression driven by FOXO1 activation and expanded host macrophages. Either depletion of host macrophages or deletion of VEGFA from GPR65 KO tumors restored responsiveness to CAR-T cell treatment. Anti-VEGFa therapy, in combination with CD19-CAR-T, prolongs the survival of GPR65-KO tumor-bearing mice in pre-clinical models. Our results indicate that GPR65 may be a useful biomarker for tumor responsiveness to CAR-T cell therapy and further suggest VEGFA or host macrophages as therapeutic targets to improve CAR-T efficacy.
Project description:Chimeric antigen receptor (CAR)-T cell therapy has shown promise in treating CD19+ hematological tumors, but some patients fail to respond. Here we used an immune-competent mouse model of B cell acute lymphoblastic leukemia (B-ALL) to assess clonal tumor populations with distinct responses to CAR-T cell therapy. We identified GPR65 as a determinant of tumor responsiveness to CAR-T cell therapy, with high GPR65 expression associated with a complete response. GPR65 KO tumors were resistant to CAR-T treatment in vivo. This was associated with increased tumor VEGFA expression driven by FOXO1 activation and expanded host macrophages. Either depletion of host macrophages or deletion of VEGFA from GPR65 KO tumors restored responsiveness to CAR-T cell treatment. Anti-VEGFa therapy, in combination with CD19-CAR-T, prolongs the survival of GPR65-KO tumor-bearing mice in pre-clinical models. Our results indicate that GPR65 may be a useful biomarker for tumor responsiveness to CAR-T cell therapy and further suggest VEGFA or host macrophages as therapeutic targets to improve CAR-T efficacy.
Project description:Chimeric antigen receptor (CAR)-T cell therapy has shown promise in treating CD19+ hematological tumors, but some patients fail to respond. Here we used an immune-competent mouse model of B cell acute lymphoblastic leukemia (B-ALL) to assess clonal tumor populations with distinct responses to CAR-T cell therapy. We identified GPR65 as a determinant of tumor responsiveness to CAR-T cell therapy, with high GPR65 expression associated with a complete response. GPR65 KO tumors were resistant to CAR-T treatment in vivo. This was associated with increased tumor VEGFA expression driven by FOXO1 activation and expanded host macrophages. Either depletion of host macrophages or deletion of VEGFA from GPR65 KO tumors restored responsiveness to CAR-T cell treatment. Anti-VEGFa therapy, in combination with CD19-CAR-T, prolongs the survival of GPR65-KO tumor-bearing mice in pre-clinical models. Our results indicate that GPR65 may be a useful biomarker for tumor responsiveness to CAR-T cell therapy and further suggest VEGFA or host macrophages as therapeutic targets to improve CAR-T efficacy.
Project description:A significant challenge for chimeric antigen receptor (CAR) T cell therapy against glioblastoma (GBM) is its immunosuppressive tumor microenvironment (TME), which is densely populated and supported by protumoral glioma-associated microglia and macrophages (GAMs). Targeting CD47, a don't-eat-me signal overexpressed by tumor cells, disrupts the CD47-SIRPalpha axis and induces GAM phagocytic function. However, antibody-mediated CD47 blockade monotherapy is associated with toxicity and low bioavailability in solid tumors. To overcome these limitations, we combined local CAR T cell therapy with paracrine GAM modulation to effectively eliminate GBM. To this end, we engineered a new CAR T cell against epidermal growth factor receptor variant III (EGFRvIII) that constitutively secretes a signal regulatory protein gamma (SIRPgamma)-related protein (SGRP) with high affinity to CD47. Anti-EGFRvIII-SGRP CAR T cells eliminated EGFRvIII+ GBM in a dose-dependent manner in vitro and eradicated orthotopically xenografted EGFRvIII-mosaic GBM by locoregional application in vivo. This resulted in significant tumor-free long-term survival, followed by partial tumor control upon tumor re-challenge. Combining anti-CD47 antibodies with anti-EGFRvIII CAR T cells failed to achieve a similar therapeutic effect, underscoring the importance of sustained paracrine GAM modulation. Multidimensional brain immunofluorescence microscopy and in-depth spectral flow cytometry on GBM-xenografted brains showed that anti-EGFRvIII-SGRP CAR T cells accelerated GBM clearance, increased CD68+ cell trafficking to tumor scar sites and promoted GAM-mediated tumor cell uptake. In a peripheral lymphoma mouse xenograft model, anti-CD19-SGRP CAR T cells had superior efficacy to conventional anti-CD19 CAR T cells. Validation on human GBM explants revealed that anti-EGFRvIII-SGRP CAR T cells had a similar tumor-killing capacity to anti-EGFRvIII CAR monotherapy but showed a slight improvement in the maintenance of tumor-infiltrated CD14+ cells. Thus, local anti-EGFRvIII-SGRP CAR T cell therapy combines the potent antitumor effect of engineered T cells with the modulation of the surrounding innate immune TME. This results in the additive elimination of bystander EGFRvIII- tumor cells in a manner that overcomes the main mechanisms of CAR T cell therapy resistance, including tumor innate immune suppression and antigen escape.
Project description:Adoptive cell therapy, a subset of cancer immunotherapy, is collection of therapeutic approaches which aim to redirect the immune system by reprogramming patient T-cells to target antigenic molecules differentially and specifically expressed in certain cancers. One promising immunotherapy technique is CAR T-cell therapy, where cancer cells are targeted through the expression a chimeric antigen receptor (CAR), a synthetic trans- membrane receptor that functionally compensates for the T-cell receptor (TCR) but targets a tumor associated antigen on the cancer cell surface. While CAR T-cell therapy is promising with two clinically approved second-generation CARs (Kymriah and Yescarta), few studies have investigated the mechanism of signal propagation in T-cells and no studies have investigated the potential signaling response in the target cells. To gain further insight to CAR-based signaling, we stimulated third generation CD19 CAR-expressing Jurkat T-cells by co-culture with SILAC labeled CD19HI Raji B-cells and used two phosphoenrichment strategies coupled with liquid chromatography-tandem mass spec- trometry (LC-MS/MS) to detect and analyze global phosphorylation changes in both cell populations. Analysis of the phosphopeptides originating from the CD19-CAR T cells revealed an increase in many phosphorylation events necessary for canonical TCR signaling. We also observed for the first time a significant decrease in B-cell receptor- related phosphopeptide abundance in CD19HI Raji B-cells after co-culture with CD19-targetted CAR T-cells.
Project description:Chimeric antigen receptor (CAR) T cells mediate potent antigen-specific antitumor activity, however, their indirect effects on the endogenous immune system is not well characterized. Remarkably, we demonstrate that CAR T cell treatment of mouse syngeneic glioblastoma activates intratumoral myeloid cells and induces endogenous T cell memory responses coupled with feed-forward propagation of CAR T responses. IFNγ production by CAR T cells and IFNγ-responsiveness of host immune cells is critical for tumor immune landscape remodeling to promote a more activated and less suppressive tumor microenvironment. The clinical relevance of these observations is supported by studies showing that human IL13Rα2-CAR T cells activate patient-derived endogenous T cells and monocyte/macrophages through IFNg-signaling, as well as induce the generation of tumor-specific T cell responses in a responding patient with GBM. These studies establish that CAR T therapy has the potential to shape the tumor microenvironment, creating a context permissible for eliciting endogenous antitumor immunity.
Project description:Chimeric antigen receptor (CAR) therapy targeting CD19 yielded remarkable outcomes in patients with acute lymphoblastic leukemia. To identify potential CAR targets in acute myeloid leukemia (AML), we probed the AML surfaceome for over-expressed molecules with potentially tolerable systemic expression. We integrated large transcriptomics and proteomics data sets from malignant and normal tissues, and developed an algorithm to identify potential targets expressed in leukemia stem cells, but not in normal CD34+CD38– hematopoietic cells, T cells or vital tissues. As these investigations did not uncover candidate targets with a profile as favorable as CD19, we developed a generalizable combinatorial targeting strategy fulfilling stringent efficacy and safety criteria. Our findings indicate that several target pairings hold great promise for CAR therapy of AML.
Project description:<p>Anti-CD19 chimeric antigen receptor (CAR) T-cell therapy for relapsed or refractory (r/r) large B-cell lymphoma (LBCL) results in durable response in only a subset of patients. MYC overexpression in LBCL tumors is associated with poor response to treatment. We tested whether a MYC-driven polyamine signature, as a liquid biopsy, is predictive of response to anti-CD19 CAR-T therapy in patients with r/r LBCL. Elevated plasma acetylated polyamines were associated with non-durable response. Concordantly, increased expression of spermidine synthase, a key enzyme which regulates levels of acetylated spermidine, was prognostic for survival in r/r LBCL. A broad metabolite screen identified additional markers which resulted in a 6-marker panel (6MetP) consisting of acetylspermidine, diacetylspermidine and lysophospholipids which was validated in an independent set from another institution as predictive of non-durable response to CAR T therapy. A polyamine centric metabolomics liquid biopsy panel has predictive value for response to CAR-T therapy in r/r LBCL. </p>
Project description:Anti-cancer immunotherapy approaches are increasingly coveted. Chimeric antigen receptor (CAR)-T cell therapy has been shown to be an effective treatment for hematological tumors, but the treatment of solid tumors still lacks effectiveness, due to lower intra-tumor infiltration of CAR-T cells and tumor-induced immunosuppression. Macrophages represent a very large proportion of the tumor environment, participate in many aspects to tumor development and therefore represent interesting therapeutic targets. Macrophages can infiltrate solid tumor tissue and interact with almost all cellular components in the tumor microenvironment. In addition, macrophages can also promote a direct anti-tumor response by phagocyting tumor cells. We have developed macrophages expressing a CAR receptor against the HER2 antigen. The CAR receptor possesses an intracellular domain CD3ζ having homology with the protein FcεRI-γ, which once activated by the recognition antibody-antigen, induces the phagocytic activity of macrophages. 72% of macrophages express the CAR after transduction. CAR-M can specifically phagocyte HER2 coated-beads in a much more effective way than WT macrophages. We have then confirmed the capacity of CAR-M to phagocyte HER2+ cancer cell lines. Co-culture of CAR-M with breast cancer tumoroids (HER2+ or HER2-) has also been performed demonstrating their efficacy in a more complex environment. However, in the tumor microenvironment, due to their plasticity, macrophages tend to adopt an anti-inflammatory phenotype losing their anti-tumor activities. We have therefore developed a combined strategy by inhibiting two proprotein convertases, Furin and PC1/3 in CAR-M. The inhibition of furin or PC1/3 induces an increase in pro-inflammatory markers and maintains macrophage activation in the presence of cancer cells. In addition, HER2+ CAR-M with shFurin or shPC1/3 greatly increases the phagocytic activity on Her2+ beads or Her2+ tumors. These enzymes are therefore phenotypic regulators of macrophages. Our strategy is therefore based on a double activation of tumor-infiltrating macrophages. The first one consists in boosting the phagocytic activity of macrophages by having them express a CAR receptor targeting a tumor antigen. The second allows their reprogramming towards a pro- inflammatory phenotype by the inhibition of Furin and/or PC1/3 proprotein convertases
Project description:CAR T-cell therapy has led to tremendous successes in the treatment of B-cell malignancies. However, 30%-50% of treated patients relapse – often with reduced target antigen expression. We report that anti-CD19 CAR T-cells cause a rapid reduction of CD19 expression within hours in CAR-T exposed CD19+ B-ALL cells. Initially, anti-CD19 CAR T-cells cause CD19 clusters at the T-cell – leukemia cell interface followed by CD19 internalization and decreased CD19 surface expression. Subsequently, CD19 expression is repressed by transcriptional rewiring. Using single-cell RNA-seq and single-cell ATAC-seq we demonstrate that a subset of CD19low cells that are refractory to CAR T-cell killing employ transcriptional programs of physiological B-cell activation and germinal center reaction in order to sustain decreased CD19 expression. Inhibiting B-cell activation programs with the BTK inhibitor ibrutinib increased the cytotoxic efficacy of anti-CD19 CAR T-cells without effecting CAR T-cell viability. These results demonstrate transcriptional plasticity as an underlying mechanism of CAR T-resistance and highlight the importance of combining CAR T-cell therapy with targeted therapies that aim to overcome this plasticity.