Locoregional CAR T cells for children with CNS tumors: Clinical procedure and catheter safety.

Central nervous system (CNS) tumors are the most common solid malignancy in the pediatric population. Based on adoptive cellular therapy's clinical success against childhood leukemia and the preclinical efficacy against pediatric CNS tumors, chimeric antigen receptor (CAR) T cells offer hope of improving outcomes for recurrent tumors and universally fatal diseases such as diffuse intrinsic pontine glioma (DIPG). However, a major obstacle for tumors of the brain and spine is ineffective T cell chemotaxis to disease sites. Locoregional CAR T cell delivery via infusion through an intracranial catheter is currently under study in multiple early phase clinical trials. Here, we describe the Seattle Children's single-institution experience including the multidisciplinary process for the preparation of successful, repetitive intracranial T cell infusion for children and the catheter-related safety of our 307 intracranial CAR T cell doses.
Competing Interests: Declaration of Competing Interest M.C.J. has interests in Umoja Biopharma, City of Hope and Juno Therapeutics, a Bristol-Myers Squibb (BMS) company. M.C.J. is a seed investor and holds ownership equity in Umoja, serves as a member of the Umoja Joint Steering Committee, and is a Board Observer of the Umoja Board of Directors. M.C.J. is an inventor of patents licensed to Umoja Biopharma, City of Hope, and Juno Therapeutics. The remaining authors declare no competing financial interests. R.A.G. serves on a study steering committee for and is an inventor on a patent licensed to Juno Therapeutics, a Bristol Myers Squibb company, has served on advisory boards for Novartis and Sobi, and is a consultant for Crispr Therapeutics. A.J.J. and J.B.F. are inventors on issued and pending patents related to CAR T cell therapies. All other authors declare no competing interests.
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