CAR T Cells with Enhanced Sensitivity to B Cell Maturation Antigen for the Targeting of B Cell Non-Hodgkin's Lymphoma and Multiple Myeloma

用于靶向治疗B细胞非霍奇金淋巴瘤和多发性骨髓瘤的对B细胞成熟抗原具有增强敏感性的CAR-T细胞

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作者:Julia Bluhm ,Elisa Kieback ,Stephen F Marino ,Felix Oden ,Jörg Westermann ,Markus Chmielewski ,Hinrich Abken ,Wolfgang Uckert ,Uta E Höpken ,Armin Rehm

Abstract

Autologous T cells genetically modified with a chimeric antigen receptor (CAR) redirected at CD19 have potent activity in the treatment of B cell leukemia and B cell non-Hodgkin's lymphoma (B-NHL). Immunotherapies to treat multiple myeloma (MM) targeted the B cell maturation antigen (BCMA), which is expressed in most cases of MM. We developed a humanized CAR with specificity for BCMA based on our previously generated anti-BCMA monoclonal antibody. The targeting single-chain variable fragment (scFv) domain exhibited a binding affinity in the low nanomolar range, conferring T cells with high functional avidity. Redirecting T cells by this CAR allowed us to explore BCMA as an alternative target for mature B-NHLs. We validated BCMA expression in diffuse large B cell lymphoma, follicular lymphoma, mantle cell lymphoma, and chronic lymphocytic leukemia. BCMA CAR T cells triggered target cell lysis with an activation threshold in the range of 100 BCMA molecules, which allowed for an efficient eradication of B-NHL cells in vitro and in vivo. Our data corroborate BCMA is a suitable target in B cell tumors beyond MM, providing a novel therapeutic option for patients where BCMA is expressed at low abundance or where anti-CD19 immunotherapies have failed due to antigen loss. Keywords: B cell maturation antigen; B cell non-Hodgkin’s lymphoma; adoptive T cell therapy; chimeric antigen receptor T cells; multiple myeloma.

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