8 research outputs found
Externally-Controlled Systems for Immunotherapy: From Bench to Bedside
We thank GENYO Institute and LentiStem Biotech for the
support to compile of the necessary information to write this
review. We also thank Fundación Poco Frecuente (FPF) and
Asociación Española de Enfermos con Glucogenosis (AEEG) for
their kindly support.Immunotherapy is a very promising therapeutic approach against cancer that is
particularly effective when combined with gene therapy. Immuno-gene therapy
approaches have led to the approval of four advanced therapy medicinal products
(ATMPs) for the treatment of p53-deficient tumors (Gendicine and Imlygic), refractory
acute lymphoblastic leukemia (Kymriah) and large B-cell lymphomas (Yescarta). In
spite of these remarkable successes, immunotherapy is still associated with severe
side effects for CD19+ malignancies and is inefficient for solid tumors. Controlling
transgene expression through an externally administered inductor is envisioned as a
potent strategy to improve safety and efficacy of immunotherapy. The aim is to develop
smart immunogene therapy-based-ATMPs, which can be controlled by the addition
of innocuous drugs or agents, allowing the clinicians to manage the intensity and
durability of the therapy. In the present manuscript, we will review the different inducible,
versatile and externally controlled gene delivery systems that have been developed and
their applications to the field of immunotherapy. We will highlight the advantages and
disadvantages of each system and their potential applications in clinics.Spanish ISCIII Health Research FundEuropean Union (EU)
PI12/01097
PI15/02015
PI18/00337
PI18/00330CECEyUCSyF of the Junta de Andalucia FEDER/European Cohesion Fund (FSE) for Andalusia
2016000073391-TRA
2016000073332-TRA
PI-57069
PAIDI-Bio326
PI-0014-2016Nicolas Monardes regional Ministry of Health
0006/2018Spanish Government
FPU16/05467
FPU17/02268MCI
DIN2018-01018
Efficacy and safety of universal (TCRKO) ARI-0001 CAR-T cells for the treatment of B-cell lymphoma
Autologous T cells expressing the Chimeric Antigen Receptor (CAR) have been
approved as advanced therapy medicinal products (ATMPs) against several
hematological malignancies. However, the generation of patient-specific CART
products delays treatment and precludes standardization. Allogeneic off-theshelf
CAR-T cells are an alternative to simplify this complex and timeconsuming
process. Here we investigated safety and efficacy of knocking out
the TCR molecule in ARI-0001 CAR-T cells, a second generation aCD19 CAR
approved by the Spanish Agency of Medicines and Medical Devices (AEMPS)
under the Hospital Exemption for treatment of patients older than 25 years with
Relapsed/Refractory acute B cell lymphoblastic leukemia (B-ALL). We first
analyzed the efficacy and safety issues that arise during disruption of the TCR
gene using CRISPR/Cas9. We have shown that edition of TRAC locus in T cells
using CRISPR as ribonuleorproteins allows a highly efficient TCR disruption
(over 80%) without significant alterations on T cells phenotype and with an
increased percentage of energetic mitochondria. However, we also found that
efficient TCRKO can lead to on-target large and medium size deletions,
indicating a potential safety risk of this procedure that needs monitoring.
Importantly, TCR edition of ARI-0001 efficiently prevented allogeneic
responses and did not detectably alter their phenotype, while maintaining a
similar anti-tumor activity ex vivo and in vivo compared to unedited ARI-0001 CAR-T cells. In summary, we showed here that, although there are still some
risks of genotoxicity due to genome editing, disruption of the TCR is a feasible
strategy for the generation of functional allogeneic ARI-0001 CAR-T cells. We
propose to further validate this protocol for the treatment of patients that do
not fit the requirements for standard autologous CAR-T cells administration.Spanish ISCIII Health Research FundEuropean Commission PI15/02015
PI18/00337
PI21/00298Red TerAv RD21/ 0017/0004
PI18/ 00330
PI17/00672CECEyU and CSyF of the Junta de Andalucia FEDER/European Cohesion Fund (FSE) for Andalusia 2016000073391-TRA
2016000073332-TRA
PI-57069
PAIDIBio326
CARTPI-0001- 201
PECART-0031-2020
PI0014-2016
PEER-0286-2019Spanish Government 00123009/SNEO-20191072
PLEC2021-008094regional Ministry of Health 0006/2018
C2-0002-2019Spanish Government FPU16/05467
FPU17/02268
FPU17/04327Junta de Andalucia PECART-00312020Consejeria de Salud y Familias PECART-0027-2020
MCI DIN2018-010180
DIN2020-01155
Physiological lentiviral vectors for the generation of improved CAR-T cells
Anti-CD19 chimeric antigen receptor (CAR)-T cells have
achieved impressive outcomes for the treatment of relapsed
and refractory B-lineage neoplasms.However, important limitations
still remain due to severe adverse events (i.e., cytokine
release syndrome and neuroinflammation) and relapse of
40%–50%of the treated patients.MostCAR-Tcells are generated
using retroviral vectors with strong promoters that lead to high
CAR expression levels, tonic signaling, premature exhaustion,
and overstimulation, reducing efficacy and increasing side effects.
Here, we show that lentiviral vectors (LVs) expressing the
transgene through a WAS gene promoter (AW-LVs) closely
mimic the T cell receptor (TCR)/CD3 expression kinetic upon
stimulation. These AW-LVs can generate improved CAR-T cells
as a consequence of theirmoderate andTCR-like expression profile.
Compared with CAR-T cells generated with human elongation
factor a (EF1a)-driven-LVs, AW-CAR-T cells exhibited
lower tonic signaling, higher proportion of naive and stem cell
memory T cells, less exhausted phenotype, and milder secretion
of tumor necrosis factor alpha (TNF-a) and interferon (IFN)-ɣ
after efficient destruction of CD19+ lymphoma cells, both
in vitro and in vivo.Moreover, we also showed their improved efficiency
using an in vitro CD19+ pancreatic tumor model. We
finally demonstrated the feasibility of large-scale manufacturing
ofAW-CAR-T cells in good manufacturing practice (GMP)-like
conditions. Based on these data, we propose the use of AW-LVs
for the generation of improved CAR-T products.Spanish ISCIII Health Research FundEuropean Commission PI15/02015
PI18/00337
PI21/00298
RD21/0017/0004
PI18/00330
PI17/00672CSyF of the Junta de Andalucia FEDER/European Cohesion Fund (FSE) for Andalusia 2016000073391-TRA
2016000073332-TRA
PI-57069
PA IDI-Bio326
CARTPI-0001-201
PECART-0031-2020
Red RANTECAR CAR-T 2019 00400200101918
PLEC2021-008094
PI-0014-2016
PEER-0286-2019Spanish Government PLEC2021-008094
00123009/SNEO-20191072Nicolas Monardes contracts from regional Ministry of Health 0006/2018
C2-0002-2019German Research Foundation (DFG) FPU16/05467
FPU17/02268
FPU17/04327
MCI DIN2018-010180Fundacion Andaluza Progreso y SaludGerman Research Foundation (DFG) PEJ-2018-001760-AJunta de Andalucia PE-0223-2018Biomedicine Programme of the University of Granada (Spain
Lentiviral vectors for inducible, transactivator-free advanced therapy medicinal products: Application to CAR-T cells
Controlling transgene expression through an externally
administered inductor is envisioned as a potent strategy
to improve safety and efficacy of gene therapy approaches.
Generally, inducible ON systems require a chimeric transcription
factor (transactivator) that becomes activated by
an inductor, which is not optimal for clinical translation
due to their toxicity. We generated previously the first
all-in-one, transactivator-free, doxycycline (Dox)-responsive
(Lent-On-Plus or LOP) lentiviral vectors (LVs) able to control
transgene expression in human stem cells. Here, we
have generated new versions of the LOP LVs and have
analyzed their applicability for the generation of inducible
advanced therapy medicinal products (ATMPs) with special
focus on primary human T cells. We have shown that, contrary
to all other cell types analyzed, an Is2 insulator must
be inserted into the 30 long terminal repeat of the LOP
LVs in order to control transgene expression in human
primary T cells. Importantly, inducible primary T cells
generated by the LOPIs2 LVs are responsive to ultralow
doses of Dox and have no changes in phenotype or function
compared with untransduced T cells. We validated
the LOPIs2 system by generating inducible CAR-T cells
that selectively kill CD19+ cells in the presence of Dox.
In summary, we describe here the first transactivatorfree,
all-one-one system capable of generating Dox-inducible
ATMPs.Spanish ISCIII Health Research FundEuropean Union (EU) PI18/00337
PI21/00298
RD21/0017/0004
PI18/00330
PI17/00672Red TerAvJunta de Andalucia FEDER/European Cohesion Fund (FSE) for AndalusiaSpanish Government PI18/00337
PI21/00298European Union-NextGenerationEU - Maria Zambrano Senior Program RD21/0017/0004
PI18/00330
PI17/00672Ministry of Health 2016000073332-TRA
PI-57069
CARTPI-0001-201
PE-CART-0031-2020
PI-0014-2016
PECART-0027-2020
ProyExcel_00875
PEER-0286-2019European Cooperation in Science and Technology (COST) 00123009/SNEO-20191072MINECO - European Regional Development Fund PLEC2021-008094Spanish Government 0006/2018FEDER/Junta de Andalucia-Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades CA21113Spanish Government SAF2015-71589-PMCI RYC-2016-21395German Research Foundation (DFG) PY20_00619 y A-CTS-28_UGR20Biomedicine Program of the University of Granada (Spain) FPU16/05467
FPU17/02268
FPU17/04327
DIN2018-010180
DIN2020-011550
PEJ-2018-001760-
Generating universal anti-CD19 CAR T cells with a defined memory phenotype by CRISPR/Cas9 editing and safety evaluation of the transcriptome
IntroductionChimeric antigen receptor-expressing T cells (CAR T cells) have revolutionized cancer treatment, particularly in B cell malignancies. However, the use of autologous T cells for CAR T therapy presents several limitations, including high costs, variable efficacy, and adverse effects linked to cell phenotype.MethodsTo overcome these challenges, we developed a strategy to generate universal and safe anti-CD19 CAR T cells with a defined memory phenotype. Our approach utilizes CRISPR/Cas9 technology to target and eliminate the B2M and TRAC genes, reducing graft-versus-host and host-versus-graft responses. Additionally, we selected less differentiated T cells to improve the stability and persistence of the universal CAR T cells. The safety of this method was assessed using our CRISPRroots transcriptome analysis pipeline, which ensures successful gene knockout and the absence of unintended off-target effects on gene expression or transcriptome sequence.ResultsIn vitro experiments demonstrated the successful generation of functional universal CAR T cells. These cells exhibited potent lytic activity against tumor cells and a reduced cytokine secretion profile. The CRISPRroots analysis confirmed effective gene knockout and no unintended off-target effects, validating it as a pioneering tool for on/off-target and transcriptome analysis in genome editing experiments.DiscussionOur findings establish a robust pipeline for manufacturing safe, universal CAR T cells with a favorable memory phenotype. This approach has the potential to address the current limitations of autologous CAR T cell therapy, offering a more stable and persistent treatment option with reduced adverse effects. The use of CRISPRroots enhances the reliability and safety of gene editing in the development of CAR T cell therapies.ConclusionWe have developed a potent and reliable method for producing universal CAR T cells with a defined memory phenotype, demonstrating both efficacy and safety in vitro. This innovative approach could significantly improve the therapeutic landscape for patients with B cell malignancies
Using Gene Editing Approaches to Fine-Tune the Immune System
Genome editing technologies not only provide unprecedented opportunities to study
basic cellular system functionality but also improve the outcomes of several clinical
applications. In this review, we analyze various gene editing techniques used to finetune
immune systems from a basic research and clinical perspective. We discuss
recent advances in the development of programmable nucleases, such as zinc-finger
nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and clustered
regularly interspaced short palindromic repeat (CRISPR)-Cas-associated nucleases. We
also discuss the use of programmable nucleases and their derivative reagents such
as base editing tools to engineer immune cells via gene disruption, insertion, and
rewriting of T cells and other immune components, such natural killers (NKs) and
hematopoietic stem and progenitor cells (HSPCs). In addition, with regard to chimeric
antigen receptors (CARs), we describe how different gene editing tools enable healthy
donor cells to be used in CAR T therapy instead of autologous cells without risking
graft-versus-host disease or rejection, leading to reduced adoptive cell therapy costs
and instant treatment availability for patients. We pay particular attention to the delivery
of therapeutic transgenes, such as CARs, to endogenous loci which prevents collateral
damage and increases therapeutic effectiveness. Finally, we review creative innovations,
including immune system repurposing, that facilitate safe and efficient genome surgery
within the framework of clinical cancer immunotherapies.Spanish ISCIII Health Research FundEuropean Union (EU)
PI12/01097
PI15/02015
PI18/00337
PI18/00330CECEyU and CSyF councils of the Junta de Andalucia FEDER/European Cohesion Fund (FSE)
2016000073391-TRA
2016000073332-TRA
PI-57069
PAIDI-Bio326
PI-0014-2016Nicolas Monardes regional Ministry of Health
0006/2018Spanish Government
FPU16/05467
FPU17/02268Industrial Doctorate Plan MCI
DIN2018-010180SMSI
PEJ-2018-001760-ALentiStem Biotec
Physiological lentiviral vectors for the generation of improved CAR-T cells.
Anti-CD19 chimeric antigen receptor (CAR)-T cells have achieved impressive outcomes for the treatment of relapsed and refractory B-lineage neoplasms. However, important limitations still remain due to severe adverse events (i.e., cytokine release syndrome and neuroinflammation) and relapse of 40%-50% of the treated patients. Most CAR-T cells are generated using retroviral vectors with strong promoters that lead to high CAR expression levels, tonic signaling, premature exhaustion, and overstimulation, reducing efficacy and increasing side effects. Here, we show that lentiviral vectors (LVs) expressing the transgene through a WAS gene promoter (AW-LVs) closely mimic the T cell receptor (TCR)/CD3 expression kinetic upon stimulation. These AW-LVs can generate improved CAR-T cells as a consequence of their moderate and TCR-like expression profile. Compared with CAR-T cells generated with human elongation factor α (EF1α)-driven-LVs, AW-CAR-T cells exhibited lower tonic signaling, higher proportion of naive and stem cell memory T cells, less exhausted phenotype, and milder secretion of tumor necrosis factor alpha (TNF-α) and interferon (IFN)-ɣ after efficient destruction of CD19+ lymphoma cells, both in vitro and in vivo. Moreover, we also showed their improved efficiency using an in vitro CD19+ pancreatic tumor model. We finally demonstrated the feasibility of large-scale manufacturing of AW-CAR-T cells in guanosine monophosphate (GMP)-like conditions. Based on these data, we propose the use of AW-LVs for the generation of improved CAR-T products
DataSheet_1_Efficacy and safety of universal (TCRKO) ARI-0001 CAR-T cells for the treatment of B-cell lymphoma.pdf
Autologous T cells expressing the Chimeric Antigen Receptor (CAR) have been approved as advanced therapy medicinal products (ATMPs) against several hematological malignancies. However, the generation of patient-specific CAR-T products delays treatment and precludes standardization. Allogeneic off-the-shelf CAR-T cells are an alternative to simplify this complex and time-consuming process. Here we investigated safety and efficacy of knocking out the TCR molecule in ARI-0001 CAR-T cells, a second generation αCD19 CAR approved by the Spanish Agency of Medicines and Medical Devices (AEMPS) under the Hospital Exemption for treatment of patients older than 25 years with Relapsed/Refractory acute B cell lymphoblastic leukemia (B-ALL). We first analyzed the efficacy and safety issues that arise during disruption of the TCR gene using CRISPR/Cas9. We have shown that edition of TRAC locus in T cells using CRISPR as ribonuleorproteins allows a highly efficient TCR disruption (over 80%) without significant alterations on T cells phenotype and with an increased percentage of energetic mitochondria. However, we also found that efficient TCRKO can lead to on-target large and medium size deletions, indicating a potential safety risk of this procedure that needs monitoring. Importantly, TCR edition of ARI-0001 efficiently prevented allogeneic responses and did not detectably alter their phenotype, while maintaining a similar anti-tumor activity ex vivo and in vivo compared to unedited ARI-0001 CAR-T cells. In summary, we showed here that, although there are still some risks of genotoxicity due to genome editing, disruption of the TCR is a feasible strategy for the generation of functional allogeneic ARI-0001 CAR-T cells. We propose to further validate this protocol for the treatment of patients that do not fit the requirements for standard autologous CAR-T cells administration.</p