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Longitudinal PET imaging demonstrates biphasic CAR T cell responses in survivors
Yogindra Vedvyas, … , John Babich, Moonsoo M. Jin
Yogindra Vedvyas, … , John Babich, Moonsoo M. Jin
Published November 17, 2016
Citation Information: JCI Insight. 2016;1(19):e90064. https://doi.org/10.1172/jci.insight.90064.
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Research Article Immunology Therapeutics

Longitudinal PET imaging demonstrates biphasic CAR T cell responses in survivors

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Abstract

Clinical monitoring of adoptive T cell transfer (ACT) utilizes serial blood analyses to discern T cell activity. While useful, these data are 1-dimensional and lack spatiotemporal information related to treatment efficacy or toxicity. We utilized a human genetic reporter, somatostatin receptor 2 (SSTR2), and PET, to quantitatively and longitudinally visualize whole-body T cell distribution and antitumor dynamics using a clinically approved radiotracer. Initial evaluations determined that SSTR2-expressing T cells were detectable at low densities with high sensitivity and specificity. SSTR2-based PET was applied to ACT of chimeric antigen receptor (CAR) T cells targeting intercellular adhesion molecule-1, which is overexpressed in anaplastic thyroid tumors. Timely CAR T cell infusions resulted in survival of tumor-bearing mice, while later infusions led to uniform death. Real-time PET imaging revealed biphasic T cell expansion and contraction at tumor sites among survivors, with peak tumor burden preceding peak T cell burden by several days. In contrast, nonsurvivors displayed unrelenting increases in tumor and T cell burden, indicating that tumor growth was outpacing T cell killing. Thus, longitudinal PET imaging of SSTR2-positive ACT dynamics enables prognostic, spatiotemporal monitoring with unprecedented clarity and detail to facilitate comprehensive therapy evaluation with potential for clinical translation.

Authors

Yogindra Vedvyas, Enda Shevlin, Marjan Zaman, Irene M. Min, Alejandro Amor-Coarasa, Spencer Park, Susan Park, Keon-Woo Kwon, Turner Smith, Yonghua Luo, Dohyun Kim, Young Kim, Benedict Law, Richard Ting, John Babich, Moonsoo M. Jin

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Figure 2

Quantitative PET/CT measurement of DOTATOC uptake by Jurkat tumors and statistical analysis.

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Quantitative PET/CT measurement of DOTATOC uptake by Jurkat tumors and s...
(A) Tumor volume (mm3) plotted against number of days after xenograft. (B) Measured DOTATOC uptake is quantified as percentage injection dose per volume (%ID/cm3) for Jurkat tumors (100%–0% SSTR2+) over the course of tumor growth. (C) Representative PET/CT images of mice xenografted with Jurkat T cells at 0%, 0.1%, 1%, 10%, and 100% SSTR2 expression. Images are maximum intensity projections (MIPs) of the entire mouse body (~20-mm-thick plane). PET intensity is pseudocolored in the range of 0–10 %ID/cm3. (D and G) DOTATOC uptake (%ID/cm3) for Jurkat tumors less or greater than 65 mm3, respectively. (E and H) Simulated Gaussian distribution as a function of the measured mean and standard deviation of DOTATOC uptake for each percentage SSTR2+ tumor when the volume is less or greater than 65 mm3, respectively. (F and I) Receiver operating characteristic (ROC) curves of percentage sensitivity and specificity are shown for tumors less than 65 mm3 (D) and greater than 65 mm3 (G). ** P < 0.01 vs. 0%, ***P < 0.001 vs. 0%, by Student’s t test.

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