Granulocyte-Macrophage Colony-Stimulating Factor and CAR-T Technology for Solid Tumors in Experiment

DV Zaytsev1, EK Zaikova1,2, AS Golovkin1, ER Bulatov3, AKh Valiullina3, RM Mirgayazova3, AA Daks2, AYu Zaritskey1, AV Petukhov1,2

1 VA Almazov National Medical Research Center, 2 Akkuratova str., Saint Petersburg, Russian Federation, 197341

2 Institute of Citology, 4 Tikhoretskii pr-t, Saint Petersburg, Russian Federation, 194064

3 Kazan (Privolzhskii) Federal University, 18 Kremlevskaya str., Kazan, Russian Federation, 420008

For correspondence: Daniil Vladislavovich Zaytsev, 2 Akkuratova str., Saint Petersburg, Russian Federation, 197341; Tel.: +7(981)727-16-74; e-mail: zaicev_daniil@mail.ru

For citation: Zaytsev DV, Zaikova EK, Golovkin AS, et al. Granulocyte-Macrophage Colony-Stimulating Factor and CAR-T Technology for Solid Tumors in Experiment. Clinical oncohematology. 2020;13(2):115–22 (In Russ).

DOI: 10.21320/2500-2139-2020-13-2-115-122


ABSTRACT

Background. Cytokines are considered as important factors that enhance the efficacy of CAR-T cell therapy. Besides, they are key elements of the pathogenesis of cytokine release syndrome and neurotoxicity in applying the CAR-T technology. However, cytokine effects in the context of CAR-T therapy have not yet been properly studied.

Aim. To quantitatively assess cytokine secretion using multiplex assay with co-incubation of anti-CD19 CAR-T lymphocytes with epithelial HeLa and A431 cell lines expressing CD19 on their surface.

Materials & Methods. T-lymphocytes were transduced with the lentiviral vector containing anti-СD19-CAR gene. CAR expression was tested based on GFP reporter using flow cytometry. To confirm a specific CAR-T cell activation response to tumor antigen, the levels of interleukin-2, interferon-γ, and tumor necrosis factor-α were measured by means of immunoassay. Cytotoxic activity of CAR-T lymphocytes obtained was examined with their direct co-culturing with target cells. The levels of cytokines isolated prior to and after incubation of targets with CAR-T cells were compared using multiplex assay.

Results. The level of some proinflammatory cytokines (interleukin-6, interleukin-1β, interferon-γ) (< 0.01) increased. The difference in the levels of anti-inflammatory cytokines (interleukin-4, interleukin-10) was inconsiderable, and in the HeLa cell line experiment it was insignificant (> 0.05). The concentration of granulocyte-macrophage colony-stimulating factor (GM-CSF) was many times higher after incubation with CAR-T lymphocytes (< 0.01).

Conclusion. The trial revealed multiple enhancement of GM-CSF, one of the key elements of the pathogenesis of cytokine release syndrome and CAR-T-associated neurotoxicity. The results of further studies of GM-CSF can contribute to improving the efficacy of CAR-T therapy with considerably lower toxicity.

Keywords: CAR-T cells, GM-CSF, cytokines, immunotherapy.

Received: January 10, 2020

Accepted: March 28, 2020

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REFERENCES

  1. Stenken JA, Poschenrieder AJ. Bioanalytical Chemistry of Cytokines – a review. Analyt Chim Acta. 2015;853:95–115. doi: 10.1016/j.aca.2014.10.009.

  2. Zhang JM, An J. Cytokines, Inflammation and Pain. Int Anesthesiol Clin. 2007;45(2):27–37. doi: 10.1097/AIA.0b013e318034194e.

  3. Xu XJ, Song DG, Poussin M, et al. Multiparameter comparative analysis reveals differential impacts of various cytokines on CART cell phenotype and function ex vivo and in vivo. Oncotarget. 2016;7(50):82354–68. doi: 10.18632/oncotarget.10510.

  4. DeRenzo C, Gottschalk S. Genetic Modification Strategies to Enhance CAR T Cell Persistence for Patients With Solid Tumors. Front Immunol. 2019;10:218. doi: 10.3389/fimmu.2019.00218.

  5. Shimabukuro-Vornhagen A, Godel P, Subklewe M, et al. Cytokine release syndrome. J Immunother Cancer. 2018;6(1):56. doi: 10.1186/s40425-018-0343-9.

  6. Schmidts A, Maus MV. Making CAR T Cells a Solid Option for Solid Tumors. Front Immunol. 2018;9:2593. doi: 10.3389/fimmu.2018.02593.

  7. Martinez M, Moon EK. CAR T Cells for Solid Tumors: New Strategies for Finding, Infiltrating, and Surviving in the Tumor Microenvironment. Front Immunol. 2019;10:128. doi: 10.3389/fimmu.2019.00128.

  8. Chinnasamy D, Yu Z, Kerkar SP, et al. Local delivery of interleukin-12 using T cells targeting VEGF receptor-2 eradicates multiple vascularized tumors in mice. Clin Cancer Res. 2012;18(6):1672–83. doi: 10.1158/1078-0432.CCR-11-3050.

  9. Kochenderfer JN, Feldman SA, Zhao Y, et al. Construction and Preclinical Evaluation of an Anti-CD19 Chimeric Antigen Receptor. J Immunother. 2009;32(7):689–702. doi: 10.1097/cji.0b013e3181ac6138.

  10. Masters JR. HeLa cells 50 years on: the good, the bad and the ugly. Nat Rev Cancer. 2002;2(4):315–9. doi: 10.1038/nrc775.

  11. Bortolomai I, Canevari S, Facetti I, et al. Tumor initiating cells: Development and critical characterization of a model derived from the A431 carcinoma cell line forming spheres in suspension. Cell Cycle. 2010;9(6):1194–206. doi: 10.4161/cc.9.6.11108.

  12. Sanjana NE, Shalem O, Zhang F. Improved vectors and genome-wide libraries for CRISPR screening. Nat Meth. 2014;11(8):783–4. doi: 10.1038/nmeth.3047.

  13. Milone M, Fish J, Carpenito C, et al. Chimeric Receptors Containing CD137 Signal Transduction Domains Mediate Enhanced Survival of T Cells and Increased Antileukemic Efficacy In Vivo. Mol Ther. 2009;17(8):1453–64. doi: 10.1038/mt.2009.83.

  14. Петухов А.В., Маркова В.А., Моторин Д.В. и др. Получение CAR T-лимфоцитов, специфичных к CD19, и оценка их функциональной активности in vitro. Клиническая онкогематология. 2018;11(1):1–9. doi: 10.21320/2500-2139-2018-11-1-1-9.

    [Petukhov AV, Markova VA, Motorin DV, et al. Manufacturing of CD19 Specific CAR T-Cells and Evaluation of their Functional Activity in Vitro. Clinical oncohematology. 2018;11(1):1–9. doi: 10.21320/2500-2139-2018-11-1-1-9. (In Russ)]

  15. Yanez L, Sanchez-Escamilla M, Perales MA. CAR T Cell Toxicity: Current Management and Future Directions. HemaSphere. 2019;3(2):e186. doi: 10.1097/HS9.0000000000000186.

  16. Barrett DM, Teachey DT, Grupp SA. Toxicity management for patients receiving novel T-cell engaging therapies. Curr Opin Pediatr. 2014;26(1):43–9. doi: 10.1097/MOP.0000000000000043.

  17. Giavridis T, van der Stegen SJC, Eyquem J, et al. CAR T cell-induced cytokine release syndrome is mediated by macrophages and abated by IL-1 blockade. Nat Med. 2018;24(6):731–8. doi: 10.1038/s41591-018-0041-7.

  18. Jones G, Ding C. Tocilizumab: A review of its safety and efficacy in rheumatoid arthritis. Clin Med Ins Arthrit Musculoskel Dis. 2010;3:81–9. doi: 10.4137/cmamd.s4864.

  19. Davila ML, Riviere I, Wang X, et al. Efficacy and toxicity management of 19-28z CAR T cell therapy in B cell acute lymphoblastic leukemia. Mol Ther. 2014;22:s295–s296. doi: 10.1016/s1525-0016(16)35779-3.

  20. Hunter BD, Jacobson CA. CAR T-cell associated neurotoxicity: Mechanisms, clinicopathologic correlates, and future directions. J Nat Cancer Inst. 2019;111(7):646–54. doi: 10.1093/jnci/djz017.

  21. Sachdeva M, Duchateau P, Depil S, et al. Granulocyte-macrophage colony-stimulating factor inactivation in CAR T-cells prevents monocyte-dependent release of key cytokine release syndrome mediators. J Biol Chem. 2019;294(14):5430–7. doi: 10.1074/jbc.AC119.007558.

  22. Sterner RM, Sakemura R, Cox M, et al. GM-CSF inhibition reduces cytokine release syndrome and neuroinflammation but enhances CAR-T cell function in xenografts. Blood. 2019;133(7):697–709. doi: 10.1182/blood-2018-10-881722.

  23. Becher B, Tugues S, Greter M. GM-CSF: From Growth Factor to Central Mediator of Tissue Inflammation. Immunity. 2016;45(5):963–73. doi: 10.1016/j.immuni.2016.10.026.

  24. Wright HL, Bucknall RC, Moots RJ, et al. Analysis of SF and plasma cytokines provides insights into the mechanisms of inflammatory arthritis and may predict response to therapy. Rheumatology. 2012;51(3):451–9. doi: 10.1093/rheumatology/ker338.

  25. Donatien P, Anand U, Yiangou Y, et al. Granulocyte-macrophage colony-stimulating factor receptor expression in clinical pain disorder tissues and role in neuronal sensitization. Pain Rep. 2018;3(5):e676. doi: 10.1097/PR9.0000000000000676.

  26. Xhangolli I, Dura B, Lee G, et al. Single-cell Analysis of CAR-T Cell Activation Reveals A Mixed TH1/TH2 Response Independent of Differentiation. Genom Proteom Bioinform. 2019;17(2):129–39. doi: 10.1016/j.gpb.2019.03.002.

  27. Singh N, Hofmann TJ, Gershenson Z, et al. Monocyte lineage–derived IL-6 does not affect chimeric antigen receptor T-cell function. Cytotherapy. 2017;19(7):867–80. doi: 10.1016/j.jcyt.2017.04.001.