Development of multivalent CAR T cells as dual immunotherapy and conditioning agents

Hematopoietic stem cell transplantation (HSCT) is the only definitive cure for pediatric acute myeloid leukemia (AML). Despite adjustments in HSCT protocols and improvements in supportive care, 30% of high-risk patients who receive HSCT as part of their therapy still experience disease relapse with...

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Main Authors: Quenton Rashawn Bubb, Mohammad Balood, Gabe Eduardo Seir, Leah Swartzrock, Ethan Haslett, Katie Ho, Peng Xu, Saida G. Wiltz, Elena Sotillo, Tanja A. Gruber, Rebecca M. Richards, Crystal L. Mackall, Agnieszka Czechowicz
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Molecular Therapy: Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S295032992500013X
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author Quenton Rashawn Bubb
Mohammad Balood
Gabe Eduardo Seir
Leah Swartzrock
Ethan Haslett
Katie Ho
Peng Xu
Saida G. Wiltz
Elena Sotillo
Tanja A. Gruber
Rebecca M. Richards
Crystal L. Mackall
Agnieszka Czechowicz
author_facet Quenton Rashawn Bubb
Mohammad Balood
Gabe Eduardo Seir
Leah Swartzrock
Ethan Haslett
Katie Ho
Peng Xu
Saida G. Wiltz
Elena Sotillo
Tanja A. Gruber
Rebecca M. Richards
Crystal L. Mackall
Agnieszka Czechowicz
author_sort Quenton Rashawn Bubb
collection DOAJ
description Hematopoietic stem cell transplantation (HSCT) is the only definitive cure for pediatric acute myeloid leukemia (AML). Despite adjustments in HSCT protocols and improvements in supportive care, 30% of high-risk patients who receive HSCT as part of their therapy still experience disease relapse with high transplant-related mortality. Relapsed AML has a dismal prognosis, and novel therapies are needed. To improve upon the status quo, HSCT would more effectively eliminate relapse-initiating leukemic cells and be delivered with safer, non-genotoxic conditioning. Here, we investigate hematopoietic cytokine receptors (HCRs) and identify that KIT, MPL, and FLT3 are collectively highly expressed in virtually all pediatric AML samples studied. Further, we establish proof-of-concept of a first-in-class chimeric antigen receptor (CAR) T cell that enables simultaneous targeting of KIT, MPL, and FLT3 through a single receptor, which we term the extracellularly linked concatemeric trivalent cytokine (ELECTRIC) CAR. ELECTRIC CARs exhibit potent cytotoxicity against normal and malignant hematopoietic cells in vitro and display anti-HCR activity in a murine xenograft model. We propose that the ELECTRIC system can be the foundation to developing a non-genotoxic, anti-leukemic conditioning regimen to enable safer, more durable efficacy with minimal toxicity.
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spelling doaj-art-830b87f661534ee69ef2e3285c628ee82025-08-20T02:48:30ZengElsevierMolecular Therapy: Oncology2950-32992025-03-0133120094410.1016/j.omton.2025.200944Development of multivalent CAR T cells as dual immunotherapy and conditioning agentsQuenton Rashawn Bubb0Mohammad Balood1Gabe Eduardo Seir2Leah Swartzrock3Ethan Haslett4Katie Ho5Peng Xu6Saida G. Wiltz7Elena Sotillo8Tanja A. Gruber9Rebecca M. Richards10Crystal L. Mackall11Agnieszka Czechowicz12Stem Cell Biology and Regenerative Medicine Graduate Program, Medical Scientist Training Program, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Bioengineering, Stanford University, Stanford, CA 94305, USADepartment of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USAStanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USAStanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Pediatrics, University of Wisconsin-Madison, Madison, WI 53792, USADepartment of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA; Division of Blood and Stem Cell Transplantation and Cell Therapy, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USADepartment of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Corresponding author: Agnieszka Czechowicz, Department of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.Hematopoietic stem cell transplantation (HSCT) is the only definitive cure for pediatric acute myeloid leukemia (AML). Despite adjustments in HSCT protocols and improvements in supportive care, 30% of high-risk patients who receive HSCT as part of their therapy still experience disease relapse with high transplant-related mortality. Relapsed AML has a dismal prognosis, and novel therapies are needed. To improve upon the status quo, HSCT would more effectively eliminate relapse-initiating leukemic cells and be delivered with safer, non-genotoxic conditioning. Here, we investigate hematopoietic cytokine receptors (HCRs) and identify that KIT, MPL, and FLT3 are collectively highly expressed in virtually all pediatric AML samples studied. Further, we establish proof-of-concept of a first-in-class chimeric antigen receptor (CAR) T cell that enables simultaneous targeting of KIT, MPL, and FLT3 through a single receptor, which we term the extracellularly linked concatemeric trivalent cytokine (ELECTRIC) CAR. ELECTRIC CARs exhibit potent cytotoxicity against normal and malignant hematopoietic cells in vitro and display anti-HCR activity in a murine xenograft model. We propose that the ELECTRIC system can be the foundation to developing a non-genotoxic, anti-leukemic conditioning regimen to enable safer, more durable efficacy with minimal toxicity.http://www.sciencedirect.com/science/article/pii/S295032992500013XMT: Regular IssueCAR-TAMLpediatric AMLHSCTtrispecific
spellingShingle Quenton Rashawn Bubb
Mohammad Balood
Gabe Eduardo Seir
Leah Swartzrock
Ethan Haslett
Katie Ho
Peng Xu
Saida G. Wiltz
Elena Sotillo
Tanja A. Gruber
Rebecca M. Richards
Crystal L. Mackall
Agnieszka Czechowicz
Development of multivalent CAR T cells as dual immunotherapy and conditioning agents
Molecular Therapy: Oncology
MT: Regular Issue
CAR-T
AML
pediatric AML
HSCT
trispecific
title Development of multivalent CAR T cells as dual immunotherapy and conditioning agents
title_full Development of multivalent CAR T cells as dual immunotherapy and conditioning agents
title_fullStr Development of multivalent CAR T cells as dual immunotherapy and conditioning agents
title_full_unstemmed Development of multivalent CAR T cells as dual immunotherapy and conditioning agents
title_short Development of multivalent CAR T cells as dual immunotherapy and conditioning agents
title_sort development of multivalent car t cells as dual immunotherapy and conditioning agents
topic MT: Regular Issue
CAR-T
AML
pediatric AML
HSCT
trispecific
url http://www.sciencedirect.com/science/article/pii/S295032992500013X
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