Pilot study of T cells redirected to EGFRvIII with a chimeric antigen receptor in patients with EGFRvIII+ glioblastoma.

Authors

null

Donald M. O'Rourke

University of Pennsylvania, Philadelphia, PA

Donald M. O'Rourke , MacLean Nasrallah , Jennifer J. Morrissette , Jan J. Melenhorst , Simon F. Lacey , Keith Mansfield , Maria Martinez-Lage , Arati Suvas Desai , Steven Brem , Eileen Maloney , Suyash Mohan , Sumei Wang , Gaurav Verma , Jean-Marc Navenot , Angela Shen , Zhaohui Zheng , Bruce Levine , Hideho Okada , Carl H. June , Marcela Valderrama Maus

Organizations

University of Pennsylvania, Philadelphia, PA, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, Center for Cellular Immunotherapies, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, Novartis Institutes for Biomedical Research, Cambridge, MA, Novartis Pharma, Florham Park, NJ, Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA, University of California, San Francisco, CA

Research Funding

Other

Background: We have developed an autologous T cell product directed to the EGFR variant III mutation via lentiviral transduction of a chimeric antigen receptor (CAR), and opened an IND. We have initiated a pilot study enrolling patients with recurrent EGFRvIII-positive glioblastoma (GBM). Methods: Patients with recurrent GBM have their tumors screened for the presence of the EGFRvIII mutation by a next-generation sequencing based assay. Eligible patients undergo leukapheresis for collection of autologous T cells, which are genetically modified ex vivo to express the EGFRvIII CAR, expanded, and then cryopreserved for infusion. Results: We report results on the nine patients we have treated. To date, we have found that infusion of 1-5x108 CART-EGFRvIII cells is feasible to manufacture and infusion is safe, without evidence of off-tumor toxicity or cross-reactivity to wild type EGFR. No clinical or laboratory signs of systemic cytokine release syndrome have been observed, though elevations in serum IL-6 occur concurrently with CART-EGFRvIII expansion in the peripheral blood. One patient developed non-convulsive status epilepticus nine days after CART-EGFRvIII infusion, which resolved with standard treatment and anti-cytokine therapy. All patients have had significant expansion of CART-EGFRvIII cells between 7-10 days post-infusion, as measured by flow cytometry and quantitative PCR in peripheral blood samples. Five patients have undergone surgical resection of tumor between 6-120 days after infusion, and pathologic evaluation has demonstrated infiltration of activated CAR T cells, recruitment of new T cells (as assessed by next generation T cell receptor deep sequencing), and specific EGFRvIII target antigen loss in GBM cells in some cases. Conclusions: These findings provide evidence that CART-EGFRvIII cells are safe, without evidence of off-target toxicity or cytokine release syndrome, and are immunologically active. The data also suggest a mechanism of antigen editing by activated CART-EGFRvIII cells that track to specific EGFRvIII GBM cells. Clinical trial information: NCT02209376

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Abstract Details

Meeting

2016 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Clinical Trial Registration Number

NCT02209376

Citation

J Clin Oncol 34, 2016 (suppl; abstr 2067)

DOI

10.1200/JCO.2016.34.15_suppl.2067

Abstract #

2067

Poster Bd #

254

Abstract Disclosures

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