Neutralization of IFNγ improves the safety profile of CAR T-cells while maintaining unaffected efficacy against B-cell malignancies

Chimeric antigen receptor (CAR) T-cell therapy represents a revolutionary approach to induce long-lasting remission in patients with B-cell malignancies not responding to conventional therapies. Nevertheless, possible severe side effects, including cytokine release syndrome (CRS), neurotoxicity and macrophage activation syndrome, whose management is still challenging, as well as lack of pathophysiological experimental models to investigate novel interventions, limit the widespread use of this therapy. In light of these considerations, we developed a comprehensive humanized mouse model to investigate the role of IFNγ neutralization, provided by the clinically approved monoclonal antibody, emapalumab, in controlling severe toxicity related to CAR T cells. We demonstrated that emapalumab reduces the pro-inflammatory environment in the animal model, allowing severe CRS control and preventing brain damage, characterized by multifocal hemorrhages. Furthermore, we proved that IFNγ inhibition does not affect the ability of CAR.CD19 T cells to eradicate CD19+ lymphoma cells, both in vitro and in vivo.