Radiation therapy improves CAR T cell activity in acute lymphoblastic leukemia.
Mayumi SugitaTakahiro YamazakiMohammad AlhomoudJérémie MartinetJean-Baptiste LatoucheEncouse GoldenOlivier BoyerKoen Van BesienSilvia C FormentiLorenzo GalluzziMonica L GuzmanPublished in: Cell death & disease (2023)
Autologous T cells engineered to express a chimeric antigen receptor (CAR) specific for CD19 are approved for the treatment of various CD19 + hematological malignancies. While CAR T cells induce objective responses in a majority of patients, relapse frequently occurs upon loss of CD19 expression by neoplastic cells. Radiation therapy (RT) has been successfully employed to circumvent the loss of CAR targets in preclinical models of pancreatic cancer. At least in part, this reflects the ability of RT to elicit death receptor (DR) expression by malignant cells, enabling at least some degree of CAR-independent tumor killing. In a human model of CD19 + acute lymphoblastic leukemia (ALL), we also observed DR upregulation by RT, both in vitro and in vivo. Moreover, low-dose total body irradiation (LD-TBI) delivered to ALL-bearing mice prior to CAR T cell infusion considerably extended the overall survival benefit afforded by CAR T cells alone. Such an improved therapeutic activity was accompanied by a superior expansion of CAR T cells in vivo. These data encourage the initiation of clinical trials combining LD-TBI with CAR T cells in patients with hematological malignancies.
Keyphrases
- acute lymphoblastic leukemia
- radiation therapy
- low dose
- poor prognosis
- clinical trial
- traumatic brain injury
- induced apoptosis
- end stage renal disease
- newly diagnosed
- cell therapy
- ejection fraction
- chronic kidney disease
- bone marrow
- allogeneic hematopoietic stem cell transplantation
- big data
- stem cells
- type diabetes
- cell proliferation
- randomized controlled trial
- severe traumatic brain injury
- endothelial cells
- high dose
- cell death
- signaling pathway
- platelet rich plasma
- deep learning
- endoplasmic reticulum stress
- radiation induced
- peritoneal dialysis
- free survival
- insulin resistance
- mesenchymal stem cells
- high fat diet induced
- rectal cancer
- prognostic factors