Preclinical efficacy and safety of CD19CAR cytokine-induced killer cells transfected with sleeping beauty transposon for the treatment of acute lymphoblastic leukemia

CF Magnani, C Mezzanotte, C Cappuzzello… - Human gene …, 2018 - liebertpub.com
CF Magnani, C Mezzanotte, C Cappuzzello, M Bardini, S Tettamanti, G Fazio, LJN Cooper…
Human gene therapy, 2018liebertpub.com
Infusion of patient-derived CD19-specific chimeric antigen receptor (CAR) T cells
engineered by viral vectors achieved complete remission and durable response in relapsed
and refractory (r/r) B-lineage neoplasms. Here, we expand on those findings by providing a
preclinical evaluation of allogeneic non-viral cytokine-induced killer (CIK) cells transfected
with the Sleeping Beauty (SB) transposon CD19CAR (CARCIK-CD19). Specifically, thanks
to a large-scale 18-day manufacturing process, it was possible to achieve stable CD19CAR …
Infusion of patient-derived CD19-specific chimeric antigen receptor (CAR) T cells engineered by viral vectors achieved complete remission and durable response in relapsed and refractory (r/r) B-lineage neoplasms. Here, we expand on those findings by providing a preclinical evaluation of allogeneic non-viral cytokine-induced killer (CIK) cells transfected with the Sleeping Beauty (SB) transposon CD19CAR (CARCIK-CD19). Specifically, thanks to a large-scale 18-day manufacturing process, it was possible to achieve stable CD19CAR expression (62.425 ± 6.399%) and efficient T-cell expansion (23.36 ± 3.00-fold). Frozen/thawed CARCIK-CD19 remained fully functional both in vitro and in an established patient-derived xenograft (PDX) of MLL–ENL rearranged acute lymphoblastic leukemia (ALL). CARCIK-CD19 showed a dose-dependent antitumor response and prolonged persistence in a PDX, bearing the feature of a Philadelphia-like ALL with PAX5/AUTS2 translocation, and in a survival model of lymphoma, achieving complete eradication of disseminated tumors. Finally, the infusion of CARCIK-CD19 proved to be safe and well tolerated in a biodistribution and toxicity model. The infused cells persisted in the hematopoietic and post-injection perfused organs until the end of the study and consisted of CD8+, CD56+, and CAR+ T cells. Overall, these findings provide important implications for non-viral technology and the proof-of-concept that donor-derived CARCIK-CD19 are indeed effective against relapsed ALL, a possibility that will be tested in Phase I/II clinical trials after allogeneic hematopoietic stem-cell transplantation.
Mary Ann Liebert