Abstract

Adoptive immunotherapy with T cells genetically modified to express chimeric antigen receptors (CARs) is a promising approach to improve outcomes for cancer patients. While CAR T cell therapy is effective for hematological malignancies, there is a need to improve the efficacy of this therapeutic approach for patients with solid tumors and brain tumors. At present, several approaches are being pursued to improve the antitumor activity of CAR T cells including i) targeting multiple antigens, ii) improving T cell expansion/persistence, iii) enhancing homing to tumor sites, and iv) rendering CAR T cells resistant to the immunosuppressive tumor microenvironment (TME). Augmenting signal 3 of T cell activation by transgenic expression of cytokines or engineered cytokine receptors has emerged as a promising strategy since it not only improves CAR T cell expansion/persistence but also their ability to function in the immunosuppressive TME. In this review, we will provide an overview of cytokine biology and highlight genetic approaches that are actively being pursued to augment cytokine signaling in CAR T cells.

Highlights

  • Despite recent advances in cancer treatment, patients with relapsed or refractory disease continue to have poor outcomes and novel approaches are needed

  • Constitutive expression of IL-15 by first generation CD19-CAR T cells improved their in vivo antitumor activity and allowed cells to persist in mice for up to 110 days after tumor challenge [71]

  • Studies have highlighted that transgenic cytokines do enhance the antitumor activity of CAR T cells and modulate other cells within the tumor microenvironment (TME) and are able to induce or enhance endogenous tumor-specific immune responses

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Summary

Introduction

Despite recent advances in cancer treatment, patients with relapsed or refractory disease continue to have poor outcomes and novel approaches are needed. Constitutive expression of IL-15 by first generation CD19-CAR T cells improved their in vivo antitumor activity and allowed cells to persist in mice for up to 110 days after tumor challenge [71].

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