Abstract

BackgroundThe unprecedented efficacy of chimeric antigen receptor T (CAR-T) cell immunotherapy of CD19+ B-cell malignancies has opened a new and useful way for the treatment of malignant tumors. Nonetheless, there are still formidable challenges in the field of CAR-T cell therapy, such as the biodistribution of CAR-T cells in vivo.MethodsNALM-6, a human B-cell acute lymphoblastic leukemia (B-ALL) cell line, was used as target cells. CAR-T cells were injected into a mice model with or without target cells. Then we measured the distribution of CAR-T cells in mice. In addition, an exploratory clinical trial was conducted in 13 r/r B-cell non-Hodgkin lymphoma (B-NHL) patients, who received CAR-T cell infusion. The dynamic changes in patient blood parameters over time after infusion were detected by qPCR and flow cytometry.ResultsCAR-T cells still proliferated over time after being infused into the mice without target cells within 2 weeks. However, CAR-T cells did not increase significantly in the presence of target cells within 2 weeks after infusion, but expanded at week 6. In the clinical trial, we found that CAR-T cells peaked at 7–21 days after infusion and lasted for 420 days in peripheral blood of patients. Simultaneously, mild side effects were observed, which could be effectively controlled within 2 months in these patients.ConclusionsCAR-T cells can expand themselves with or without target cells in mice, and persist for a long time in NHL patients without serious side effects.Trial registrationThe registration date of the clinical trial is May 17, 2018 and the trial registration numbers is NCT03528421.

Highlights

  • The unprecedented efficacy of chimeric antigen receptor T (CAR-T) cell immunotherapy of CD19+ Bcell malignancies has opened a new and useful way for the treatment of malignant tumors

  • Chimeric Antigen Receptor (CAR)-T cells proliferated without target cells in NCG mice CD19 CAR-T cells containing a 4-1BB co-stimulatory domain that can improve the expansion, persistence and antitumor effect of CAR-T cells [7, 10, 11] (Fig. 1a) were produced by Immunochina Pharmaceuticals following the described process (Fig. 1b)

  • Most people believed that without target cells in mice, CAR-T cells will disappear in a short time after infusion

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Summary

Introduction

The unprecedented efficacy of chimeric antigen receptor T (CAR-T) cell immunotherapy of CD19+ Bcell malignancies has opened a new and useful way for the treatment of malignant tumors. Chimeric antigen receptor T (CAR-T) cell therapy is drawing more and more attention for treating relapsed or refractory (r/r) B-cell malignancies, including B-cell acute lymphoblastic leukemia (B-ALL) and B-cell nonHodgkin lymphoma (B-NHL) [1,2,3]. The approval of three CAR-T cell products by the US Food and Drug Administration (FDA), Yescarta, Kymriah and Tecartus, have paved the way for the clinical availability of CAR-T cell therapy [4]. There are no available standardized methods for monitoring in vivo behaviors of injected CAR-T cells. Because most of the imaging methods can only monitor the CAR-T cells in a short time, common methods for long-time monitoring are needed

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