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Abstract LB-083: Phase I study of T cells redirected to EGFRvIII with a chimeric antigen receptor in patients with EGFRvIII+ glioblastoma
We initiated a Phase I study of intravenous delivery of autologous T cells re-directed to the EGFR variant III mutation by means of a lentiviral vector encoding a chimeric antigen receptor (CAR). Patients with recurrent glioblastoma (GBM) have their tumors screened for the presence of the EGFRvIII m...
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Published in: | Cancer research (Chicago, Ill.) Ill.), 2016-07, Vol.76 (14_Supplement), p.LB-083-LB-083 |
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creator | O’Rourke, Donald M. Nasrallah, MacLean P. Morrissette, Jennifer Melenhorst, Jan J. Lacey, Simon F. Mansfield, Keith Martinez-Lage, Maria Desai, Arati Brem, Steven Maloney, Eileen Mohan, Suyash Wang, Sumei Verma, Gaurav Navenot, Jean-Marc Shen, Angela Zheng, Zhaohui Levine, Bruce L. Okada, Hideho June, Carl H. Maus, Marcela V. |
description | We initiated a Phase I study of intravenous delivery of autologous T cells re-directed to the EGFR variant III mutation by means of a lentiviral vector encoding a chimeric antigen receptor (CAR). Patients with recurrent glioblastoma (GBM) have their tumors screened for the presence of the EGFRvIII mutation by a next-generation sequencing based assay. Eligible patients undergo leukapheresis for collection of autologous T cells, which are genetically modified ex vivo to express the EGFRvIII CAR, expanded, and then cryopreserved for infusion. We report results on the nine patients we have treated. We targeted a challenging subset of GBM patients, with multi-focal residual, progressive disease refractory to standard and experimental therapies, including temozolomide, bevacizumab, and radiation. To date, we have found that infusion of 1-5×10⁁8 CART-EGFRvIII cells is feasible to manufacture and infusion is safe, without evidence of off-tumor toxicity or cross-reactivity to wild type EGFR. No clinical or laboratory signs of systemic cytokine release syndrome have been observed, though elevations in serum IL-6 occur concurrently with CART-EGFRvIII expansion in the peripheral blood. One patient developed non-convulsive status epilepticus nine days after CART-EGFRvIII infusion, which resolved with standard treatment and anti-cytokine therapy. All patients have had significant expansion of CART-EGFRvIII cells between 7-10 days post-infusion, as measured by flow cytometry and quantitative PCR in peripheral blood samples. Five patients have undergone surgical resection of tumor between 6-120 days after infusion, and pathologic evaluation has demonstrated infiltration of activated CAR T cells, recruitment of new T cells (as assessed by next generation T cell receptor deep sequencing), and specific EGFRvIII target antigen loss in GBM cells in some cases. These findings provide evidence that CART-EGFRvIII cells are safe, without evidence of off-target toxicity or cytokine release syndrome, and are immunologically active. The data also suggest a mechanism of antigen editing by activated CART-EGFRvIII cells that track to specific EGFRvIII GBM cells.
Citation Format: Donald M. O’Rourke, MacLean P. Nasrallah, Jennifer Morrissette, Jan J. Melenhorst, Simon F. Lacey, Keith Mansfield, Maria Martinez-Lage, Arati Desai, Steven Brem, Eileen Maloney, Suyash Mohan, Sumei Wang, Gaurav Verma, Jean-Marc Navenot, Angela Shen, Zhaohui Zheng, Bruce L. Levine, Hideho Okada, Carl H. June, Ma |
doi_str_mv | 10.1158/1538-7445.AM2016-LB-083 |
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Citation Format: Donald M. O’Rourke, MacLean P. Nasrallah, Jennifer Morrissette, Jan J. Melenhorst, Simon F. Lacey, Keith Mansfield, Maria Martinez-Lage, Arati Desai, Steven Brem, Eileen Maloney, Suyash Mohan, Sumei Wang, Gaurav Verma, Jean-Marc Navenot, Angela Shen, Zhaohui Zheng, Bruce L. Levine, Hideho Okada, Carl H. June, Marcela V. Maus. Phase I study of T cells redirected to EGFRvIII with a chimeric antigen receptor in patients with EGFRvIII+ glioblastoma. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-083.</description><identifier>ISSN: 0008-5472</identifier><identifier>EISSN: 1538-7445</identifier><identifier>DOI: 10.1158/1538-7445.AM2016-LB-083</identifier><language>eng</language><ispartof>Cancer research (Chicago, Ill.), 2016-07, Vol.76 (14_Supplement), p.LB-083-LB-083</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1359-2fb9099a79c6a6939752d7c313eb261695d4521eec2d44275f2b853a3dc5e6643</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>O’Rourke, Donald M.</creatorcontrib><creatorcontrib>Nasrallah, MacLean P.</creatorcontrib><creatorcontrib>Morrissette, Jennifer</creatorcontrib><creatorcontrib>Melenhorst, Jan J.</creatorcontrib><creatorcontrib>Lacey, Simon F.</creatorcontrib><creatorcontrib>Mansfield, Keith</creatorcontrib><creatorcontrib>Martinez-Lage, Maria</creatorcontrib><creatorcontrib>Desai, Arati</creatorcontrib><creatorcontrib>Brem, Steven</creatorcontrib><creatorcontrib>Maloney, Eileen</creatorcontrib><creatorcontrib>Mohan, Suyash</creatorcontrib><creatorcontrib>Wang, Sumei</creatorcontrib><creatorcontrib>Verma, Gaurav</creatorcontrib><creatorcontrib>Navenot, Jean-Marc</creatorcontrib><creatorcontrib>Shen, Angela</creatorcontrib><creatorcontrib>Zheng, Zhaohui</creatorcontrib><creatorcontrib>Levine, Bruce L.</creatorcontrib><creatorcontrib>Okada, Hideho</creatorcontrib><creatorcontrib>June, Carl H.</creatorcontrib><creatorcontrib>Maus, Marcela V.</creatorcontrib><title>Abstract LB-083: Phase I study of T cells redirected to EGFRvIII with a chimeric antigen receptor in patients with EGFRvIII+ glioblastoma</title><title>Cancer research (Chicago, Ill.)</title><description>We initiated a Phase I study of intravenous delivery of autologous T cells re-directed to the EGFR variant III mutation by means of a lentiviral vector encoding a chimeric antigen receptor (CAR). Patients with recurrent glioblastoma (GBM) have their tumors screened for the presence of the EGFRvIII mutation by a next-generation sequencing based assay. Eligible patients undergo leukapheresis for collection of autologous T cells, which are genetically modified ex vivo to express the EGFRvIII CAR, expanded, and then cryopreserved for infusion. We report results on the nine patients we have treated. We targeted a challenging subset of GBM patients, with multi-focal residual, progressive disease refractory to standard and experimental therapies, including temozolomide, bevacizumab, and radiation. To date, we have found that infusion of 1-5×10⁁8 CART-EGFRvIII cells is feasible to manufacture and infusion is safe, without evidence of off-tumor toxicity or cross-reactivity to wild type EGFR. No clinical or laboratory signs of systemic cytokine release syndrome have been observed, though elevations in serum IL-6 occur concurrently with CART-EGFRvIII expansion in the peripheral blood. One patient developed non-convulsive status epilepticus nine days after CART-EGFRvIII infusion, which resolved with standard treatment and anti-cytokine therapy. All patients have had significant expansion of CART-EGFRvIII cells between 7-10 days post-infusion, as measured by flow cytometry and quantitative PCR in peripheral blood samples. Five patients have undergone surgical resection of tumor between 6-120 days after infusion, and pathologic evaluation has demonstrated infiltration of activated CAR T cells, recruitment of new T cells (as assessed by next generation T cell receptor deep sequencing), and specific EGFRvIII target antigen loss in GBM cells in some cases. These findings provide evidence that CART-EGFRvIII cells are safe, without evidence of off-target toxicity or cytokine release syndrome, and are immunologically active. The data also suggest a mechanism of antigen editing by activated CART-EGFRvIII cells that track to specific EGFRvIII GBM cells.
Citation Format: Donald M. O’Rourke, MacLean P. Nasrallah, Jennifer Morrissette, Jan J. Melenhorst, Simon F. Lacey, Keith Mansfield, Maria Martinez-Lage, Arati Desai, Steven Brem, Eileen Maloney, Suyash Mohan, Sumei Wang, Gaurav Verma, Jean-Marc Navenot, Angela Shen, Zhaohui Zheng, Bruce L. Levine, Hideho Okada, Carl H. June, Marcela V. Maus. Phase I study of T cells redirected to EGFRvIII with a chimeric antigen receptor in patients with EGFRvIII+ glioblastoma. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. 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Patients with recurrent glioblastoma (GBM) have their tumors screened for the presence of the EGFRvIII mutation by a next-generation sequencing based assay. Eligible patients undergo leukapheresis for collection of autologous T cells, which are genetically modified ex vivo to express the EGFRvIII CAR, expanded, and then cryopreserved for infusion. We report results on the nine patients we have treated. We targeted a challenging subset of GBM patients, with multi-focal residual, progressive disease refractory to standard and experimental therapies, including temozolomide, bevacizumab, and radiation. To date, we have found that infusion of 1-5×10⁁8 CART-EGFRvIII cells is feasible to manufacture and infusion is safe, without evidence of off-tumor toxicity or cross-reactivity to wild type EGFR. No clinical or laboratory signs of systemic cytokine release syndrome have been observed, though elevations in serum IL-6 occur concurrently with CART-EGFRvIII expansion in the peripheral blood. One patient developed non-convulsive status epilepticus nine days after CART-EGFRvIII infusion, which resolved with standard treatment and anti-cytokine therapy. All patients have had significant expansion of CART-EGFRvIII cells between 7-10 days post-infusion, as measured by flow cytometry and quantitative PCR in peripheral blood samples. Five patients have undergone surgical resection of tumor between 6-120 days after infusion, and pathologic evaluation has demonstrated infiltration of activated CAR T cells, recruitment of new T cells (as assessed by next generation T cell receptor deep sequencing), and specific EGFRvIII target antigen loss in GBM cells in some cases. These findings provide evidence that CART-EGFRvIII cells are safe, without evidence of off-target toxicity or cytokine release syndrome, and are immunologically active. The data also suggest a mechanism of antigen editing by activated CART-EGFRvIII cells that track to specific EGFRvIII GBM cells.
Citation Format: Donald M. O’Rourke, MacLean P. Nasrallah, Jennifer Morrissette, Jan J. Melenhorst, Simon F. Lacey, Keith Mansfield, Maria Martinez-Lage, Arati Desai, Steven Brem, Eileen Maloney, Suyash Mohan, Sumei Wang, Gaurav Verma, Jean-Marc Navenot, Angela Shen, Zhaohui Zheng, Bruce L. Levine, Hideho Okada, Carl H. June, Marcela V. Maus. Phase I study of T cells redirected to EGFRvIII with a chimeric antigen receptor in patients with EGFRvIII+ glioblastoma. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-083.</abstract><doi>10.1158/1538-7445.AM2016-LB-083</doi></addata></record> |
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title | Abstract LB-083: Phase I study of T cells redirected to EGFRvIII with a chimeric antigen receptor in patients with EGFRvIII+ glioblastoma |
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