[HTML][HTML] Development and evaluation of an optimal human single-chain variable fragment-derived BCMA-targeted CAR T cell vector

EL Smith, M Staehr, R Masakayan, IJ Tatake… - Molecular Therapy, 2018 - cell.com
EL Smith, M Staehr, R Masakayan, IJ Tatake, TJ Purdon, X Wang, P Wang, H Liu, Y Xu…
Molecular Therapy, 2018cell.com
B cell maturation antigen (BCMA) has recently been identified as an important multiple
myeloma (MM)-specific target for chimeric antigen receptor (CAR) T cell therapy. In CAR T
cell therapy targeting CD19 for lymphoma, host immune anti-murine CAR responses limited
the efficacy of repeat dosing and possibly long-term persistence. This clinically relevant
concern can be addressed by generating a CAR incorporating a human single-chain
variable fragment (scFv). We screened a human B cell-derived scFv phage display library …
B cell maturation antigen (BCMA) has recently been identified as an important multiple myeloma (MM)-specific target for chimeric antigen receptor (CAR) T cell therapy. In CAR T cell therapy targeting CD19 for lymphoma, host immune anti-murine CAR responses limited the efficacy of repeat dosing and possibly long-term persistence. This clinically relevant concern can be addressed by generating a CAR incorporating a human single-chain variable fragment (scFv). We screened a human B cell-derived scFv phage display library and identified a panel of BCMA-specific clones from which human CARs were engineered. Despite a narrow range of affinity for BCMA, dramatic differences in CAR T cell expansion were observed between unique scFvs in a repeat antigen stimulation assay. These results were confirmed by screening in a MM xenograft model, where only the top preforming CARs from the repeat antigen stimulation assay eradicated disease and prolonged survival. The results of this screening identified a highly effective CAR T cell therapy with properties, including rapid in vivo expansion (>10,000-fold, day 6), eradication of large tumor burden, and durable protection to tumor re-challenge. We generated a bicistronic construct including a second-generation CAR and a truncated-epithelial growth factor receptor marker. CAR T cell vectors stemming from this work are under clinical investigation.
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