Preclinical in vivo modeling of cytokine release syndrome induced by ErbB-retargeted human T cells: identifying a window of therapeutic opportunity?

J Immunol. 2013 Nov 1;191(9):4589-98. doi: 10.4049/jimmunol.1301523. Epub 2013 Sep 23.

Abstract

The ErbB network is dysregulated in many solid tumors. To exploit this, we have developed a chimeric Ag receptor (CAR) named T1E28z that targets several pathogenetically relevant ErbB dimers. T1E28z is coexpressed with a chimeric cytokine receptor named 4αβ (combination termed T4), enabling the selective expansion of engineered T cells using IL-4. Human T4(+) T cells exhibit antitumor activity against several ErbB(+) cancer types. However, ErbB receptors are also expressed in several healthy tissues, raising concerns about toxic potential. In this study, we have evaluated safety of T4 immunotherapy in vivo using a SCID beige mouse model. We show that the human T1E28z CAR efficiently recognizes mouse ErbB(+) cells, rendering this species suitable to evaluate preclinical toxicity. Administration of T4(+) T cells using the i.v. or intratumoral routes achieves partial tumor regression without clinical or histopathologic toxicity. In contrast, when delivered i.p., tumor reduction is accompanied by dose-dependent side effects. Toxicity mediated by T4(+) T cells results from target recognition in both tumor and healthy tissues, leading to release of both human (IL-2/IFN-γ) and murine (IL-6) cytokines. In extreme cases, outcome is lethal. Both toxicity and IL-6 release can be ameliorated by prior macrophage depletion, consistent with clinical data that implicate IL-6 in this pathogenic event. These data demonstrate that CAR-induced cytokine release syndrome can be modeled in mice that express target Ag in an appropriate distribution. Furthermore, our findings argue that ErbB-retargeted T cells can achieve therapeutic benefit in the absence of unacceptable toxicity, providing that route of administration and dose are carefully optimized.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Cell Line
  • Humans
  • Immunotherapy, Adoptive*
  • Interferon-gamma / biosynthesis
  • Interferon-gamma / metabolism
  • Interleukin-2 / biosynthesis
  • Interleukin-2 / metabolism
  • Interleukin-4
  • Interleukin-6 / biosynthesis
  • Interleukin-6 / metabolism
  • Macrophages
  • Mice
  • Mice, SCID
  • Neoplasms / immunology*
  • Neoplasms / therapy
  • Oncogene Proteins v-erbB / metabolism*
  • Recombinant Fusion Proteins / therapeutic use*
  • Signal Transduction
  • T-Lymphocytes / metabolism*

Substances

  • Interleukin-2
  • Interleukin-6
  • Oncogene Proteins v-erbB
  • Recombinant Fusion Proteins
  • Interleukin-4
  • Interferon-gamma