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Benign tumors in TSC are amenable to treatment by GD3 CAR T cells in mice
Ancy Thomas, Saurav Sumughan, Emilia R. Dellacecca, Rohan S. Shivde, Nicola Lancki, Zhussipbek Mukhatayev, Cristina C. Vaca, Fei Han, Levi Barse, Steven W. Henning, Jesus Zamora-Pineda, Suhail Akhtar, Nikhilesh Gupta, Jasmine O. Zahid, Stephanie R. Zack, Prathyaya Ramesh, Dinesh Jaishankar, Agnes S.Y. Lo, Joel Moss, Maria M. Picken, Thomas N. Darling, Denise M. Scholtens, Daniel F. Dilling, Richard P. Junghans, I. Caroline Le Poole
Ancy Thomas, Saurav Sumughan, Emilia R. Dellacecca, Rohan S. Shivde, Nicola Lancki, Zhussipbek Mukhatayev, Cristina C. Vaca, Fei Han, Levi Barse, Steven W. Henning, Jesus Zamora-Pineda, Suhail Akhtar, Nikhilesh Gupta, Jasmine O. Zahid, Stephanie R. Zack, Prathyaya Ramesh, Dinesh Jaishankar, Agnes S.Y. Lo, Joel Moss, Maria M. Picken, Thomas N. Darling, Denise M. Scholtens, Daniel F. Dilling, Richard P. Junghans, I. Caroline Le Poole
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Research Article Immunology Therapeutics

Benign tumors in TSC are amenable to treatment by GD3 CAR T cells in mice

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Abstract

Mutations underlying disease in tuberous sclerosis complex (TSC) give rise to tumors with biallelic mutations in TSC1 or TSC2 and hyperactive mammalian target of rapamycin complex 1 (mTORC1). Benign tumors might exhibit de novo expression of immunogens, targetable by immunotherapy. As tumors may rely on ganglioside D3 (GD3) expression for mTORC1 activation and growth, we compared GD3 expression in tissues from patients with TSC and controls. GD3 was overexpressed in affected tissues from patients with TSC and also in aging Tsc2+/– mice. As GD3 overexpression was not accompanied by marked natural immune responses to the target molecule, we performed preclinical studies with GD3 chimeric antigen receptor (CAR) T cells. Polyfunctional CAR T cells were cytotoxic toward GD3-overexpressing targets. In mice challenged with Tsc2–/– tumor cells, CAR T cells substantially and durably reduced the tumor burden, correlating with increased T cell infiltration. We also treated aged Tsc2+/– heterozygous (>60 weeks) mice that carry spontaneous Tsc2–/– tumors with GD3 CAR or untransduced T cells and evaluated them at endpoint. Following CAR T cell treatment, the majority of mice were tumor free while all control animals carried tumors. The outcomes demonstrate a strong treatment effect and suggest that targeting GD3 can be successful in TSC.

Authors

Ancy Thomas, Saurav Sumughan, Emilia R. Dellacecca, Rohan S. Shivde, Nicola Lancki, Zhussipbek Mukhatayev, Cristina C. Vaca, Fei Han, Levi Barse, Steven W. Henning, Jesus Zamora-Pineda, Suhail Akhtar, Nikhilesh Gupta, Jasmine O. Zahid, Stephanie R. Zack, Prathyaya Ramesh, Dinesh Jaishankar, Agnes S.Y. Lo, Joel Moss, Maria M. Picken, Thomas N. Darling, Denise M. Scholtens, Daniel F. Dilling, Richard P. Junghans, I. Caroline Le Poole

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Figure 6

GD3 CAR T cells effectively treat spontaneous tumors arising in Tsc2+/– mice.

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GD3 CAR T cells effectively treat spontaneous tumors arising in Tsc2+/– ...
(A) Tumor-bearing Tsc2+/– mice quantified 2 weeks after initial adoptive transfer of >60-week-old mice, n = 10 and 8 for CAR T and untransduced T cell recipients, respectively. The presence of visible tumors was evaluated in major organs, and mice were scored as tumor positive or negative. A 2-sided Fisher’s exact test for count data was used to compare the treatment groups at n = 10 and n = 8 for the control and treatment groups, respectively. ***P = 0.0002. (B) Representative images of the liver and kidney tumors of the untransduced T cell recipient and GD3 CAR T cell recipient mice. Dashed lines surround tumors and arrowheads point to cysts. (C) Representative histology images showing cysts in the kidney and tumors in the liver of untransduced T cell recipient mice. Arrows show lesions in cross section (cysts in kidney and tumor cells in liver tissue). (D) Area occupied by cysts or (E) tumors in representative kidney and liver tissues of untransduced and GD3 CAR T cell–injected mice quantified by multiple observers (n = 4). One-tailed paired Student’s t tests were used to compare outcomes for 4 evaluators. (F) Ki-67–expressing cells in kidney and liver tissues quantified by immunostaining (n = 3). One-tailed t tests with unequal variance were used to compare outcomes among both treatment groups within each tissue type. (G) CD3+ T cells in available liver and kidney tissues quantified by immunostaining (n = 3–5). (H) CD4/CD8 ratios in kidney and liver tissues (n = 3–5) and (I) GD3 CAR T cells observed in representative kidney and liver tissues (n = 5) quantified by immunostaining. One-tailed t tests with unequal variance were used to compare outcomes among both treatment groups within each tissue type. *P < 0.05, **P < 0.01, ***P < 0.001. Graphs show individual values, mean values ± SD.

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