Chlorotoxin-directed CAR T cell therapy for recurrent glioblastoma: Interim clinical experience demonstrating feasibility and safety

氯毒素靶向CAR-T细胞疗法治疗复发性胶质母细胞瘤:中期临床经验表明其可行性和安全性

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作者:Michael E Barish ,Maryam Aftabizadeh ,Jonathan Hibbard ,M Suzette Blanchard ,Julie R Ostberg ,Jamie R Wagner ,Mishika Manchanda ,Jinny Paul ,Tracy Stiller ,Brenda Aguilar ,Renate Starr ,Leonidas Arvanitis ,Julie A Ressler ,Julie Kilpatrick ,Yuthana Kong ,Dongrui Wang ,Stephen J Forman ,Massimo D'Apuzzo ,Christine E Brown ,Behnam Badie

Abstract

A challenge in treating glioblastoma (GBM) is its phenotypic heterogeneity between patients and within tumors. Chlorotoxin (CLTX), a peptide from scorpion venom, broadly binds glioma cells through a mechanism involving surface matrix metalloproteinase-2 (MMP-2). We previously developed chimeric antigen receptor (CAR) T cells incorporating CLTX as the GBM recognition domain. Here, we report interim clinical experience of a phase 1 trial evaluating intracavity/intratumoral (ICT) delivery of CLTX-CAR T cells in four patients with MMP-2-expressing recurrent GBM (NCT04214392), with the primary objectives of feasibility and safety. The therapy is well tolerated with no dose-limiting toxicities. Three of the four participants (75%) exhibit a best response of stable disease. CLTX-CAR T cells are detected in the tumor cavity fluid and at lower levels in the blood. Human anti-CAR antibody assays do not detect humoral immunogenicity against the CLTX-CAR. These observations support further clinical evaluation of CLTX-CAR therapy.

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