Equipping CAR-modified T cells with a brake to prevent chronic adverse effects

Curr Gene Ther. 2012 Dec;12(6):493-5. doi: 10.2174/156652312803519751.

Abstract

Genetical modification of T lymphocytes by chimeric antigen receptor (CAR), which has the affinity to tumor associated antigen (TAA), can redirect the normal T lymphocytes with tumor specificity. Through optimization of the CAR construct from first generation to third generation, the properties of these CAR-modified T lymphocytes, including, cytokines release, proliferative capacity, in vivo survival time, have been remarkably improved. These improvements accelerate the clinical applications of the CAR-modified T lymphocytes. Due to CD19, and CD20 specificity, CAR-modified T lymphocytes have been clinically used to treat leukemia. Notably, T lymphocytes genetically engineered by Carl June group with CAR targeting to CD19 have expanded more than 1,000 folds by clearing all CD19 positive leukemia cells, even the normal B cells, which infiltrated in bone marrow, and survived for more than 6 months. This encouraging report demonstrates the overwhelming tumor-lytic ability of the CAR-modified T lymphocytes; it also raises the concern about the chronic toxicity. Here, we emphasize the safety concern when using the CAR-modified T lymphocytes. We also summarize strategies exploited to clear the genetically engineered T lymphocytes under an urgent condition, which increases the safety and optimizes the applications of the CAR-modified T lymphocytes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal, Murine-Derived / pharmacology
  • Antigens, CD19 / genetics
  • Antigens, CD19 / metabolism*
  • Antigens, CD20 / genetics
  • Antigens, CD20 / metabolism
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / pharmacology
  • Cell Proliferation
  • Cell Survival
  • Genetic Engineering
  • Genetic Therapy / methods
  • Humans
  • Immunotherapy, Adoptive / adverse effects*
  • Immunotherapy, Adoptive / methods
  • Leukemia / metabolism
  • Leukemia / pathology
  • Leukemia / therapy*
  • Risk Factors
  • Rituximab
  • T-Lymphocytes / metabolism*
  • T-Lymphocytes / pathology

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD19
  • Antigens, CD20
  • Antineoplastic Agents
  • Rituximab