Abstract

Cell therapy is an innovative therapeutic concept where viable cells are implanted, infused, or grafted into a patient to treat impaired or malignant tissues. The term was first introduced circa the 19th century and has since resulted in multiple breakthroughs in different fields of medicine, such as neurology, cardiology, and oncology. Lately, cell and gene therapy are merging to provide cell products with additional or enhanced properties. In this context, adoptive transfer of genetically modified cytotoxic lymphocytes has emerged as a novel treatment option for cancer patients. To this day, five cell therapy products have been FDA approved, four of which for CD19-positive malignancies and one for B-cell maturation antigen (BCMA)-positive malignancies. These are personalized immunotherapies where patient T cells are engineered to express chimeric antigen receptors (CARs) with the aim to redirect the cells against tumor-specific antigens. CAR-T cell therapies show impressive objective response rates in clinical trials that, in certain instances, may reach up to 80%. However, the life-threatening side effects associated with T cell toxicity and the manufacturing difficulties of developing personalized therapies hamper their widespread use. Recent literature suggests that Natural Killer (NK) cells, may provide a safer alternative and an ‘off-the-shelf’ treatment option thanks to their potent antitumor properties and relatively short lifespan. Here, we will discuss the potential of NK cells in CAR-based therapies focusing on the applications of CAR-NK cells in cancer therapy and beyond.

Highlights

  • Specialty section: This article was submitted to Cancer Immunity and Immunotherapy, a section of the journal Frontiers in Immunology

  • This observation was made in an acute myeloid leukemia (AML) mouse model transplanted with hematopoietic stem cell (HSC), and its translation to the clinic provided grounds to investigate haploidentical or HLAmismatched Natural Killer (NK) cells in adoptive cell transfers [36]

  • The latter could be obtained at higher numbers with less inter-donor variability and stimulation with IL-2 and IL-15 improved more their functionality compared to chimeric antigen receptors (CARs) peripheral blood (PB)-NK cells

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Summary

Engineered NK Cells Against Cancer and Their Potential Applications Beyond

Maria Karvouni 1, Marcos Vidal-Manrique 1, Andreas Lundqvist 2 and Evren Alici 1*. Specialty section: This article was submitted to Cancer Immunity and Immunotherapy, a section of the journal Frontiers in Immunology. Cell and gene therapy are merging to provide cell products with additional or enhanced properties In this context, adoptive transfer of genetically modified cytotoxic lymphocytes has emerged as a novel treatment option for cancer patients. Adoptive transfer of genetically modified cytotoxic lymphocytes has emerged as a novel treatment option for cancer patients To this day, five cell therapy products have been FDA approved, four of which for CD19-positive malignancies and one for B-cell maturation antigen (BCMA)-positive malignancies. Five cell therapy products have been FDA approved, four of which for CD19-positive malignancies and one for B-cell maturation antigen (BCMA)-positive malignancies These are personalized immunotherapies where patient T cells are engineered to express chimeric antigen receptors (CARs) with the aim to redirect the cells against tumor-specific antigens.

NK CELL BIOLOGY
ADOPTIVE NK CELL THERAPY
ALTERNATIVE NK CELL SOURCES
CRYOPRESERVATION OF NK CELLS
Limitations
GENETIC MANIPULATION OF NK CELLS
Hinge Region
Transmembrane Region
Intracellular Domains
Alternative Antigen Recognition Domains
Ectopic Cytokine Production
Safety Switches
Adapter CARs
Expression of Chemokine Receptors and Cytotoxic Ligands
Enhancing NK Cell Metabolism
Modification of Targeted Antigen Expression
Immune Checkpoint Inhibition
Therapeutic Antibodies
Oncolytic Virotherapy
Recombinant Viruses
Hematological Malignancies
Solid Tumors
Infectious Diseases
Autoimmune Diseases
Ongoing Clinical Trials
Not known Not known Not known
Findings
CONCLUDING REMARKS
Full Text
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