1. An APRIL-based chimeric antigen receptor for dual targeting of BCMA and TACI in multiple myeloma.
- Author
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Lee L, Draper B, Chaplin N, Philip B, Chin M, Galas-Filipowicz D, Onuoha S, Thomas S, Baldan V, Bughda R, Maciocia P, Kokalaki E, Neves MP, Patel D, Rodriguez-Justo M, Francis J, Yong K, and Pule M
- Subjects
- Animals, Antineoplastic Agents, Immunological chemical synthesis, Antineoplastic Agents, Immunological chemistry, Cell Line, Tumor, Cytotoxicity, Immunologic, Humans, Ligands, Mice, Molecular Targeted Therapy, Receptors, Chimeric Antigen chemical synthesis, Receptors, Chimeric Antigen chemistry, Transmembrane Activator and CAML Interactor Protein chemistry, Tumor Necrosis Factor Ligand Superfamily Member 13 chemistry, Antineoplastic Agents, Immunological therapeutic use, B-Cell Maturation Antigen metabolism, Multiple Myeloma drug therapy, Receptors, Chimeric Antigen therapeutic use, Tumor Necrosis Factor Ligand Superfamily Member 13 metabolism
- Abstract
B-cell maturation antigen (BCMA) is a promising therapeutic target for multiple myeloma (MM), but expression is variable, and early reports of BCMA targeting chimeric antigen receptors (CARs) suggest antigen downregulation at relapse. Dual-antigen targeting increases targetable tumor antigens and reduces the risk of antigen-negative disease escape. "A proliferation-inducing ligand" (APRIL) is a natural high-affinity ligand for BCMA and transmembrane activator and calcium-modulator and cyclophilin ligand (TACI). We quantified surface tumor expression of BCMA and TACI on primary MM cells (n = 50). All cases tested expressed BCMA, and 39 (78%) of them also expressed TACI. We engineered a third-generation APRIL-based CAR (ACAR), which killed targets expressing either BCMA or TACI ( P < .01 and P < .05, respectively, cf. control, effector-to-target [E:T] ratio 16:1). We confirmed cytolysis at antigen levels similar to those on primary MM, at low E:T ratios (56.2% ± 3.9% killing of MM.1s at 48 h, E:T ratio 1:32; P < .01) and of primary MM cells (72.9% ± 12.2% killing at 3 days, E:T ratio 1:1; P < .05, n = 5). Demonstrating tumor control in the absence of BCMA, we maintained cytolysis of primary tumor expressing both BCMA and TACI in the presence of a BCMA-targeting antibody. Furthermore, using an intramedullary myeloma model, ACAR T cells caused regression of an established tumor within 2 days. Finally, in an in vivo model of tumor escape, there was complete ACAR-mediated tumor clearance of BCMA
+ TACI- and BCMA- TACI+ cells, and a single-chain variable fragment CAR targeting BCMA alone resulted in outgrowth of a BCMA-negative tumor. These results support the clinical potential of this approach., (© 2018 by The American Society of Hematology.)- Published
- 2018
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