<p>The efficacy of chimeric antigen receptor (CAR) T cell therapy in solid tumours is limited by immunosuppression and antigen heterogeneity<sup><CitationRef AdditionalCitationIDS="CR2" CitationID="CR1">1</CitationRef>–<CitationRef CitationID="CR3">3</CitationRef></sup>. To overcome these barriers, ‘armoured’ CAR T cells, which secrete proinflammatory cytokines, have been developed<sup><CitationRef CitationID="CR4">4</CitationRef></sup>. However, their clinical application has been limited because of toxicity related to peripheral expression of the armouring transgene<sup><CitationRef CitationID="CR5">5</CitationRef></sup>. Here, we have developed a CRISPR knock-in strategy that leverages the regulatory mechanisms of endogenous genes to drive transgene expression in a tumour-localized manner. By screening endogenous genes with tumour-restricted expression, we have identified the <i>NR4A2</i> and <i>RGS16</i> promoters as promising candidates to support the delivery of cytokines such as IL-12 and IL-2 directly to the tumour site, leading to enhanced antitumour efficacy and long-term survival of mice in both syngeneic and xenogeneic models. This effect was concomitant with improved CAR T cell polyfunctionality, activation of endogenous antitumour immunity and a favourable safety profile, and was applicable in CAR T cells from patients.</p>

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Rewiring endogenous genes in CAR T cells for tumour-restricted payload delivery

  • Amanda X. Y. Chen,
  • Kah Min Yap,
  • Joelle S. Kim,
  • Kevin Sek,
  • Yu-Kuan Huang,
  • Phoebe A. Dunbar,
  • Volker Wiebking,
  • Jesse D. Armitage,
  • Isabelle Munoz,
  • Kirsten L. Todd,
  • Emily B. Derrick,
  • Dat Nguyen,
  • Junming Tong,
  • Cheok Weng Chan,
  • Thang X. Hoang,
  • Katherine M. Audsley,
  • Marit J. van Elsas,
  • Jim Middelburg,
  • Joel N. Lee,
  • Maria N. de Menezes,
  • Thomas J. Cole,
  • Jasmine Li,
  • Christina Scheffler,
  • Andrew M. Scott,
  • Laura K. Mackay,
  • Jason Waithman,
  • Jane Oliaro,
  • Simon J. Harrison,
  • Ian A. Parish,
  • Junyun Lai,
  • Matthew H. Porteus,
  • Imran G. House,
  • Phillip K. Darcy,
  • Paul A. Beavis

摘要

The efficacy of chimeric antigen receptor (CAR) T cell therapy in solid tumours is limited by immunosuppression and antigen heterogeneity13. To overcome these barriers, ‘armoured’ CAR T cells, which secrete proinflammatory cytokines, have been developed4. However, their clinical application has been limited because of toxicity related to peripheral expression of the armouring transgene5. Here, we have developed a CRISPR knock-in strategy that leverages the regulatory mechanisms of endogenous genes to drive transgene expression in a tumour-localized manner. By screening endogenous genes with tumour-restricted expression, we have identified the NR4A2 and RGS16 promoters as promising candidates to support the delivery of cytokines such as IL-12 and IL-2 directly to the tumour site, leading to enhanced antitumour efficacy and long-term survival of mice in both syngeneic and xenogeneic models. This effect was concomitant with improved CAR T cell polyfunctionality, activation of endogenous antitumour immunity and a favourable safety profile, and was applicable in CAR T cells from patients.