Intrinsic immunosuppressive features of monocytes suppress CAR-T19 through IL-1 pathway modulation in mantle cell lymphoma.

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作者:Yun Kun, Sakemura R Leo, Can Ismail, Gutierrez Ruiz Omar, Ogbodo Ekene J, Zhang Shuwen, Saleh Ateka, Huynh Truc N, Manriquez Roman Claudia, Sirpilla Olivia L, Stewart Carli M, Girsch James H, Feigin Jennifer M, Mai Long, Xia Hong, Kimball Brooke, Kankeu Fonkoua Lionel A, Hefazi Mehrdad, Ruff Michael W, Rohakhtar Fariborz Rakhshan, Simon Vernadette, Siegler Elizabeth L, Mattie Mike, Nguyen-Mau Sao-Mai, Filosto Simone, Kenderian Saad S
CD19-targeted chimeric antigen receptor T cells (CAR-T19) have shown remarkable success in B cell malignancies, but most patients relapse within 1-2 years. Here, we identified interleukin-1 (IL-1) receptor antagonist (IL-1ra) as a mediator of M2-like macrophage-derived inhibition of CAR-T19 in mantle cell lymphoma (MCL), as well as a potential target to enhance CAR-T19 efficacy. In preclinical models that recapitulated interactions between tumor, macrophages, and T cells, we demonstrated that M2-derived IL-1ra impairs IL-1 signaling and functions of CAR-T19. These findings were validated using clinical samples from the ZUMA-2 trial that led to the FDA approval of CAR-T19 in MCL. Single-cell RNA sequencing of CAR-T19 products and baseline myeloid cells indicated downregulated IL-1β production, enriched immunosuppressive phenotypes, and IL-1ra upregulation in the non-responder monocytes, as well as impaired IL-1β signaling and T cell functions in the non-responder CAR-T19 products. Furthermore, our preclinical studies of IL-1β showed enhanced CAR-T antitumor activities. Collectively, these data present a potential role for IL-1 signaling and IL-1ra in CAR-T19 failure.

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