作者: Serrano, Juan Antonio Camara ; Stieglitz, Elliot ; Dalal, Radhika ; Lin, Yu-Hsiu T ; Wiita, Arun P ; Shanmugam, Mala ; Phojanakong, Paul ; Karlon, William J ; Boise, Lawrence H ; Sobh, Amin ; Dupéré-Richer, Daphné ; Gil-Alós, Daniel ; Barwick, Benjamin G ; Steri, Veronica ; Kasap, Corynn ; Zakraoui, Ons ; Tariq, Isa ; Licht, Jonathan D ; Akagi, Naomi ; Rampersaud, Sham ; Geng, Huimin ; Izgutdina, Adila ; Wicaksono, Gianina ; Kawehi Kelii, K M ; Kang, Amrik ; Werner, Juwita ; Johnson, Haley ; Salangsang, Fernando ; Patiño-Escobar, Bonell ; Ramos, Emilio ; Chilakapati, Nikhil ; Rashid, Tasfia ; Barpanda, Abhilash ; Kortemme, Tanja ; Vijayanarayanan, Anjanaa
Abstract:Despite the success of BCMA-targeting CAR-Ts in multiple myeloma, patients with high-risk cytogenetic features still relapse most quickly and are in urgent need of additional therapeutic options. Here, we identify CD70, widely recognized as a favorable immunotherapy target in other cancers, as a specifically upregulated cell surface antigen in high risk myeloma tumors. We use a structure-guided design to define a CD27-based anti-CD70 CAR-T design that outperforms all tested scFv-based CARs, leading to >80-fold improved CAR-T expansion in vivo. Epigenetic analysis via machine learning predicts key transcription factors and transcriptional networks driving CD70 upregulation in high risk myeloma. Dual-targeting CAR-Ts against either CD70 or BCMA demonstrate a potential strategy to avoid antigen escape-mediated resistance. Together, these findings support the promise of targeting CD70 with optimized CAR-Ts in myeloma as well as future clinical translation of this approach.
One sentence summary:Structure-optimized CD27-based CAR-T cells targeting CD70 are a promising therapeutic option for high-risk multiple myeloma patients who are most likely to relapse on current BCMA-targeting cellular therapies.