[PDF][PDF] CAR T cells releasing IL-18 convert to T-Bethigh FoxO1low effectors that exhibit augmented activity against advanced solid tumors

M Chmielewski, H Abken - Cell reports, 2017 - cell.com
M Chmielewski, H Abken
Cell reports, 2017cell.com
Adoptive therapy with chimeric antigen receptor (CAR)-redirected T cells has achieved
remarkable efficacy in the treatment of hematopoietic malignancies. However, eradicating
large solid tumors in advanced stages of the disease remains challenging. We explored
augmentation of the anti-tumor immune reaction by establishing an acute inflammatory
reaction. Systematic screening indicates that IL-18 polarizes CAR T cells toward T-bet high
FoxO1 low effectors with an acute inflammatory response. CAR T cells engineered with …
Summary
Adoptive therapy with chimeric antigen receptor (CAR)-redirected T cells has achieved remarkable efficacy in the treatment of hematopoietic malignancies. However, eradicating large solid tumors in advanced stages of the disease remains challenging. We explored augmentation of the anti-tumor immune reaction by establishing an acute inflammatory reaction. Systematic screening indicates that IL-18 polarizes CAR T cells toward T-bethigh FoxO1low effectors with an acute inflammatory response. CAR T cells engineered with inducible IL-18 release exhibited superior activity against large pancreatic and lung tumors that were refractory to CAR T cells without cytokines. IL-18 CAR T cell treatment was accompanied by an overall change in the immune cell landscape associated with the tumor. More specifically, CD206 M1 macrophages and NKG2D+ NK cells increased in number, whereas Tregs, suppressive CD103+ DCs, and M2 macrophages decreased, suggesting that "iIL18 TRUCKs" can be used to sensitize large solid tumor lesions for successful immune destruction.
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