Article
Author: Zhuyong, Mei ; Zhang, Huimin ; Gottschalk, Stephen ; Lapteva, Natalia ; Patel, Kalyani ; Brenner, Malcolm K ; Wang, Tao ; Ramos, Carlos A ; Thakkar, Sachin G ; Lyon, Deborah ; Sweidan, Ramy ; Metelitsa, Leonid S ; Sumazin, Pavel ; Varadarajan, Navin ; Arnett, Azlann B ; Fleurence, Julien ; Ghatwai, Nisha ; Rathi, Purva ; Armaghany, Tannaz ; Dotti, Gianpietro ; Steffin, David ; Montalbano, Antonino ; Masand, Prakash ; Lopez-Terrada, Dolores ; Heczey, Andras ; Martinez, Daniel ; Grilley, Bambi J ; Lulla, Premal ; Courtney, Amy N ; Pogoriler, Jennifer ; Maris, John M ; Heslop, Helen E
Interleukin-15 (IL-15) promotes the survival of T lymphocytes and enhances the antitumour properties of chimeric antigen receptor (CAR) T cells in preclinical models of solid neoplasms in which CAR T cells have limited efficacy1-4. Glypican-3 (GPC3) is expressed in a group of solid cancers5-10, and here we report the evaluation in humans of the effects of IL-15 co-expression on GPC3-expressing CAR T cells (hereafter GPC3 CAR T cells). Cohort 1 patients ( NCT02905188 and NCT02932956 ) received GPC3 CAR T cells, which were safe but produced no objective antitumour responses and reached peak expansion at 2 weeks. Cohort 2 patients ( NCT05103631 and NCT04377932 ) received GPC3 CAR T cells that co-expressed IL-15 (15.CAR), which mediated significantly increased cell expansion and induced a disease control rate of 66% and antitumour response rate of 33%. Infusion of 15.CAR T cells was associated with increased incidence of cytokine release syndrome, which was controlled with IL-1/IL-6 blockade or rapidly ameliorated by activation of the inducible caspase 9 safety switch. Compared with non-responders, tumour-infiltrating 15.CAR T cells from responders showed repression of SWI/SNF epigenetic regulators and upregulation of FOS and JUN family members, as well as of genes related to type I interferon signalling. Collectively, these results demonstrate that IL-15 increases the expansion, intratumoural survival and antitumour activity of GPC3 CAR T cells in patients.