CAR T cells targeting BAFF-R can overcome CD19 antigen loss in B cell malignancies

H Qin, Z Dong, X Wang, WA Cheng, F Wen… - Science translational …, 2019 - science.org
H Qin, Z Dong, X Wang, WA Cheng, F Wen, W Xue, H Sun, M Walter, G Wei, DL Smith…
Science translational medicine, 2019science.org
CAR T cells targeting CD19 provide promising options for treatment of B cell malignancies.
However, tumor relapse from antigen loss can limit efficacy. We developed humanized,
second-generation CAR T cells against another B cell–specific marker, B cell activating
factor receptor (BAFF-R), which demonstrated cytotoxicity against human lymphoma and
acute lymphoblastic leukemia (ALL) lines. Adoptively transferred BAFF-R-CAR T cells
eradicated 10-day preestablished tumor xenografts after a single treatment and retained …
CAR T cells targeting CD19 provide promising options for treatment of B cell malignancies. However, tumor relapse from antigen loss can limit efficacy. We developed humanized, second-generation CAR T cells against another B cell–specific marker, B cell activating factor receptor (BAFF-R), which demonstrated cytotoxicity against human lymphoma and acute lymphoblastic leukemia (ALL) lines. Adoptively transferred BAFF-R-CAR T cells eradicated 10-day preestablished tumor xenografts after a single treatment and retained efficacy against xenografts deficient in CD19 expression, including CD19-negative variants within a background of CD19-positive lymphoma cells. Four relapsed, primary ALLs with CD19 antigen loss obtained after CD19-directed therapy retained BAFF-R expression and activated BAFF-R-CAR, but not CD19-CAR, T cells. BAFF-R-CAR, but not CD19-CAR, T cells also demonstrated antitumor effects against an additional CD19 antigen loss primary patient–derived xenograft (PDX) in vivo. BAFF-R is amenable to CAR T cell therapy, and its targeting may prevent emergence of CD19 antigen loss variants.
AAAS