Evaluating Efficacy of CD26+ CAR T Cells in an Orthotopic, Immunocompetent Mouse Model of Pancreatic Ductal Adenocarcinoma 公开

Karpovsky, Isaac (Spring 2023)

Permanent URL: https://etd.library.emory.edu/concern/etds/zc77sr59m?locale=zh
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Abstract

Pancreatic ductal adenocarcinoma (PDAC) is an extremely difficult cancer to treat, with an abysmal 12% 5-year survival rate. At present, chemotherapy confers little benefit, targeted therapies are limited in success, and surgery is considered the only curative approach. Clearly, there is an urgent need to pioneer new treatment strategies against this malignancy. Modern developments in immunotherapy research have produced new treatment options for both hematological and solid tumor malignancies, yet efficacy in PDAC remains low due to roadblocks such as identifying tumor-specific antigen targets, overcoming poor T cell persistence and viability, and improving trafficking of immune cells into the disease site. We hypothesized that enriching chimeric antigen receptor (CAR) T cells with a novel subpopulation of memory T cells characterized by high expression of the CD26 cell surface protein would bolster therapeutic persistence and improve antitumor ability when targeting the mesothelin antigen. We further speculated that treating our CAR T cells with a phosphatidylinositol kinase-3 gamma delta (PI3Kδ/γ) inhibitor ex vivo would enhance their stem-like phenotype and improve therapeutic capabilities. Herein, we investigate our orthotopic, immunocompetent mouse model’s ability to recapitulate the human PDAC tumor microenvironment (TME) and optimize our ability to produce therapeutic CAR T cells. Next, we conduct in vivo trials to test the efficacy of our novel immunotherapy and the utility of PI3Kδ/γ inhibition. Our preclinical studies find that CD4+CD26+ CAR T cells produce a therapeutic response and reduce tumor burden in immunocompetent, PDAC-bearing mice. Although a number of challenges remain, our preclinical studies produce bedrock data for the development of a new CAR T cell-mediated therapeutic approach against pancreatic cancer.

Table of Contents

INTRODUCTION 3

Pancreatic Ductal Adenocarcinoma and the Oppressive Microenvironment 4

Immunocompetent, Orthotopic Murine Models of Pancreatic Cancer 7

Chimeric Antigen Receptor T Cell Therapy: Benefits and Roadblocks 8

CD26: A Multifunctional Protein of Interest 12

Phosphatidylinositol Kinase-3 δ/γ Inhibition Enhances Therapeutic Function 13

Scope of Scientific Work 14

MATERIALS AND METHODS 15

Cell Lines and Reagents 15

Western Blot 16

T Cell Transduction 16

Luciferase Transduction 17

In Vivo Studies 17

Flow Cytometry 18

Immunohistochemistry (IHC) 18

Statistical Analysis 19

RESULTS 19

Chapter One: Desmoplasia and Therapeutic Infiltration in Orthotopic Tumor Models 19

Mesothelin is Expressed on Mouse-Derived PDAC Cell Lines 20

Syngeneic Models Differentially Affect Mouse Survival and Tumor Histology 21

Orthotopic PDAC Tumors Recapitulate the TME of GEMM Tumors 24

Desmoplastic Stroma Obstructs CAR T Cell Infiltration into the TME 26

Chapter Two: CD26 mesoCAR Development and in vitro Characterization 29

Optimized CAR T Cell Product Development 29

The in vitro Effect of Duvelisib on CD26 CAR T Cells 31

Chapter Three: Results and Limitations of Novel CD26-high mesoCAR Therapy 32

Pilot Study Shows CD26+ mesoCAR T Cell Efficacy but Fails to Surpass Control 33

Design Complications and Confounding Factors 35

DISCUSSION 38

FUTURE DIRECTIONS 45

REFERENCES 47

APPENDIX I: Protocols 52

T Cell Harvest Protocol 52

Mouse T Cell Transduction Protocol 54

Orthotopic Surgery Protocol 57

Single-Cell Clone Isolation, Expansion, and Selection Protocol: 61

APPENDIX II: Antibodies for Flow and IHC 62

CD26+ mesoCAR T Cell Panel 62

TME Infiltration Study Panel 62

IHC Antibodies 63

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