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Single-Cell RNA Analysis Reveals Cell-Intrinsic Functions of CAR T Cells Correlating with Response in a Phase II Study of Lymphoma Patients
Department of Immunology, Genetics and Pathology, Uppsala University, Science for Life Laboratory, Uppsala, Sweden.
Department of Immunology, Genetics and Pathology, Uppsala University, Science for Life Laboratory, Uppsala, Sweden.
Department of Immunology, Genetics and Pathology, Uppsala University, Science for Life Laboratory, Uppsala, Sweden.
Department of Immunology, Genetics and Pathology, Uppsala University, Science for Life Laboratory, Uppsala, Sweden.
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2023 (English)In: Clinical Cancer Research, ISSN 1078-0432, E-ISSN 1557-3265, Vol. 29, no 20, p. 4139-4152Article in journal (Refereed) Published
Abstract [en]

Purpose: Although CD19 chimeric antigen receptor T cells (CAR-T) therapy has shown remarkable success in B-cell malignancies, a substantial fraction of patients do not obtain a long-term clinical response. This could be influenced by the quality of the individual CAR-T infusion product. To shed some light on this, clinical outcome was correlated to characteristics of CAR-T infusion products. Patients and Methods: In this phase II study, patients with B-cell lymphoma (n ¼ 23) or leukemia (n ¼ 1) received one or two infusions of third-generation CD19-directed CAR-Ts (2 × 108/m2). The clinical trial was registered at clinicaltrials. gov: NCT03068416. We investigated the transcriptional profile of individual CD19 CAR-T infusion products using targeted single-cell RNA sequencing and multicolor flow cytometry. Results: Two CAR-T infusions were not better than one in the settings used in this study. As for the CAR-T infusion products, we found that effector-like CD8þCAR-Ts with a high polyfunctionality, high cytotoxic and cytokine production profile, and low dysfunctional signature were associated with clinical response. An extended ex vivo expansion time during CAR-T manufacturing negatively influenced the proportion of effector CD8þCAR-Ts in the infusion product. Conclusions: We identified cell-intrinsic characteristics of effector CD8þCAR-Ts correlating with response that could be used as an indicator for clinical outcome. The results in the study also serve as a guide to CAR-T manufacturing practices. ©2023 The Authors; Published by the American Association for Cancer Research.

Place, publisher, year, edition, pages
American Association for Cancer Research Inc. , 2023. Vol. 29, no 20, p. 4139-4152
Keywords [en]
CD19 antigen; CD27 antigen; interleukin 2 receptor alpha; antigen expression; Article; B cell lymphoma; CD8+ T lymphocyte; cell subpopulation; chimeric antigen receptor immunotherapy; clinical article; clinical feature; clinical outcome; cohort analysis; controlled study; correlational study; cytokine production; cytotoxicity; disease association; ex vivo study; flow cytometry; gene cluster; genetic transcription; human; human cell; leukemia; phase 2 clinical trial; phenotype; RNA analysis; single cell analysis; treatment indication
National Category
Immunology in the medical area
Identifiers
URN: urn:nbn:se:liu:diva-200764DOI: 10.1158/1078-0432.CCR-23-0178ISI: 001189711100016PubMedID: 37540566Scopus ID: 2-s2.0-85175294587OAI: oai:DiVA.org:liu-200764DiVA, id: diva2:1835932
Note

Funding Agencies|Swedish Research Council [2019-01326, 2019-01721]; Swedish Cancer Society [19 0184Pj, 20 0756 PjF, 20 1303 PjF]; AFA Insurance for regenerative medicine; Lions Cancer Fund at Uppsala University Hospital; Swedish State Support for Clinical Research; Barncancerfonden [TJ 2019-0014]; Knut and Alice Wallenberg Foundation, National Bioinformatics Infrastructure Sweden at SciLifeLab [KAW 2017.0003]

Available from: 2024-02-07 Created: 2024-02-07 Last updated: 2024-12-02

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Mirabello, Claudio

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