Search

As an adoptive cellular therapy, Chimeric Antigen Receptor T-cell (CAR T-cell) therapy has shown remarkable success in hematological malignancies, but only limited efficacy against solid tumors. Compared with blood cancers, solid tumors present a unique set of challenges that ultimately neutralize the function of CAR T-cells. One such barrier is antigen heterogeneity - variability in the expression of the antigen on tumor cells. Success of CAR T-cell therapy in solid tumors is unlikely unless almost all the tumor cells express the specific antigen that CAR T-cells target. A critical question for solving the heterogeneity problem is whether CAR T therapy induces bystander effects, such as antigen spreading. Antigen spreading occurs when CAR T-cells activate other endogenous antitumor CD8 T cells against antigens that were not originally targeted. In this work, we develop a mathematical model of CAR T-cell therapy for solid tumors that takes into consideration both antigen heterogeneity and bystander effects. Our model is based on in vivo treatment data that includes a mixture of target antigen-positive and target antigen-negative tumor cells. We use our model to simulate large cohorts of virtual patients to gain a better understanding of the relationship between bystander killing. We also investigate several strategies for enhancing the bystander effect and thus increasing the overall efficacy of CAR T-cell therapy for solid tumor.

Linear structural equation models relate the components of a random vector using linear interdependencies and Gaussian noise. Each such model can be naturally associated with a mixed graph whose vertices correspond to the components of the random vector. The graph contains directed edges that represent the linear relationships between components, and bidirected edges that encode unobserved confounding. We study the problem of generic identifiability, that is, whether a generic choice of linear and confounding effects can be uniquely recovered from the joint covariance matrix of the observed random vector. An existing combinatorial criterion for establishing generic identifiability is the half-trek criterion (HTC), which uses the existence of trek systems in the mixed graph to iteratively discover generically invertible linear equation systems in polynomial time. By focusing on edges one at a time, we establish new sufficient and necessary conditions for generic identifiability of edge effects extending those of the HTC. In particular, we show how edge coefficients can be recovered as quotients of subdeterminants of the covariance matrix, which constitutes a determinantal generalization of formulas obtained when using instrumental variables for identification.