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Sensitive and adaptable pharmacological control of CAR T cells through extracellular receptor dimerization
Wai-Hang Leung, Joel Gay, Unja Martin, Tracy E. Garrett, Holly M. Horton, Michael T. Certo, Bruce R. Blazar, Richard A. Morgan, Philip D. Gregory, Jordan Jarjour, Alexander Astrakhan
Wai-Hang Leung, Joel Gay, Unja Martin, Tracy E. Garrett, Holly M. Horton, Michael T. Certo, Bruce R. Blazar, Richard A. Morgan, Philip D. Gregory, Jordan Jarjour, Alexander Astrakhan
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Research Article Oncology Therapeutics

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

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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 composed 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 antitumor potency compared with 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 retargeting modules, potentially extending antigen targeting. Overall, this regulatable CAR design has exquisite drug sensitivity, provides robust antitumor responses, and is flexible for multiplex antigen targeting or retargeting, which may further assist the development of safe, potent, and durable T cell therapeutics.

Authors

Wai-Hang Leung, Joel Gay, Unja Martin, Tracy E. Garrett, Holly M. Horton, Michael T. Certo, Bruce R. Blazar, Richard A. Morgan, Philip D. Gregory, Jordan Jarjour, Alexander Astrakhan

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Figure 6

CD19-DARIC T cells control tumor growth in vivo with nonimmunosuppressive rapamycin dosing.

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CD19-DARIC T cells control tumor growth in vivo with nonimmunosuppressiv...
(A) Outline of the in vivo experiment for analyzing CD19-DARIC activity at low rapamycin dosing. (B) Summary bioluminescence reading for all the experimental groups. Black and blue dashed lines represent initial T cell injection and cessation of rapamycin dosing, respectively. Data presented as mean and standard deviation of 5 animals per group. (C) Trough rapamycin levels in whole blood were analyzed by liquid chromatography–tandem mass spectrometry (LC-MS/MS). Analysis was done at 24 hours (0.1 and 0.01) or 48 hours (0.1 q.a.d.) following the last rapamycin injection. (D) The bioluminescence traces for individual animals from each dose group shown in B are represented as black lines. The animals were tracked by regular imaging and rapamycin dosing was restarted when tumor regrowth was detected (red lines).

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