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Leukemia. 2018 Sep;32(9):1970-1983. doi: 10.1038/s41375-018-0065-5. Epub 2018 Feb 20.

An "off-the-shelf" fratricide-resistant CAR-T for the treatment of T cell hematologic malignancies.

Author information

1
Department of Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA. matthewcooper@wustl.edu.
2
Department of Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
3
Department of Internal Medicine, Division of Dermatology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
4
Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA.
5
McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO, 63108, USA.
6
Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USA.
7
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA.
8
Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA, 02215, USA.
9
Department of Internal Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA. jdipersi@wustl.edu.

Abstract

T cell malignancies represent a group of hematologic cancers with high rates of relapse and mortality in patients for whom no effective targeted therapies exist. The shared expression of target antigens between chimeric antigen receptor (CAR) T cells and malignant T cells has limited the development of CAR-T because of unintended CAR-T fratricide and an inability to harvest sufficient autologous T cells. Here, we describe a fratricide-resistant "off-the-shelf" CAR-T (or UCART7) that targets CD7+ T cell malignancies and, through CRISPR/Cas9 gene editing, lacks both CD7 and T cell receptor alpha chain (TRAC) expression. UCART7 demonstrates efficacy against human T cell acute lymphoblastic leukemia (T-ALL) cell lines and primary T-ALL in vitro and in vivo without the induction of xenogeneic GvHD. Fratricide-resistant, allo-tolerant "off-the-shelf" CAR-T represents a strategy for treatment of relapsed and refractory T-ALL and non-Hodgkin's T cell lymphoma without a requirement for autologous T cells.

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