VIRUS-SPECIFIC IMMUNE CELLS EXPRESSING CHIMERIC ANTIGEN RECEPTORS

Abstract

Virus-specific immune cells, comprising a chimeric antigen receptor (CAR) or nucleic acid encoding a CAR, wherein the CAR comprises: (i) an antigen-binding domain which binds specifically to CD30, (ii) a transmembrane domain, and (iii) a signalling domain, wherein the signalling domain comprises: (a) an amino acid sequence derived from the intracellular domain of CD28, and (b) an amino acid sequence comprising an immunoreceptor tyrosine-based activation motif (ITAM), are disclosed. Also disclosed are methods for producing and compositions comprising such cells.

Claims

1. A virus-specific immune cell, comprising a chimeric antigen receptor (CAR) or nucleic acid encoding a CAR, wherein the CAR comprises: (i) an antigen-binding domain which binds specifically to CD30, (ii) a transmembrane domain, and (iii) a signalling domain, wherein the signalling domain comprises: (a) an amino acid sequence derived from the intracellular domain of CD28, and (b) an amino acid sequence comprising an immunoreceptor tyrosine-based activation motif (ITAM).

2. The virus-specific immune cell according to claim 1 or claim 2, wherein the signalling domain comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:26.

3. The virus-specific immune cell according to claim 1 or claim 2, wherein the transmembrane domain is derived from the transmembrane domain of CD28.

4. The virus-specific immune cell according to any one of claims 1 to 3, wherein the transmembrane domain comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:20.

5. The virus-specific immune cell according to any one of claims 1 to 4, wherein the antigen-binding domain comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:14, and an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:15.

6. The virus-specific immune cell according to any one of claims 1 to 5, wherein the antigen-binding domain comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:18.

7. The virus-specific immune cell according to any one of claims 1 to 6, wherein the signalling domain comprises: (a) an amino acid sequence derived from the intracellular domain of CD3ζ.

8. The virus-specific immune cell according to any one of claims 1 to 7, wherein the signalling domain comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:25.

9. The virus-specific immune cell according to any one of claims 1 to 8, wherein the CAR additionally comprises a hinge region provided between the antigen-binding domain and the transmembrane domain.

10. The virus-specific immune cell according to claim 9, wherein the hinge region comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:33.

11. The virus-specific immune cell according to any one of claims 1 to 10, wherein the CAR comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:35 or 36.

12. The virus-specific immune cell according to any one of claims 1 to 11, wherein the virus-specific immune cell comprises a CAR comprising an antigen-binding domain which binds specifically to a target antigen other than CD30, or nucleic acid encoding a CAR comprising an antigen-binding domain which binds specifically to a target antigen other than CD30.

13. A virus-specific immune cell, comprising: a chimeric antigen receptor (CAR) or nucleic acid encoding a CAR, wherein the CAR comprises: (i) an antigen-binding domain which binds specifically to CD30, (ii) a transmembrane domain, and (iii) a signalling domain comprising an immunoreceptor tyrosine-based activation motif (ITAM); wherein the virus-specific immune cell comprises a CAR comprising an antigen-binding domain which binds specifically to a target antigen other than CD30, or nucleic acid encoding a CAR comprising an antigen-binding domain which binds specifically to a target antigen other than CD30.

14. The virus-specific immune cell according to claim 12 or claim 13, wherein the virus-specific immune cell comprises more than one non-identical CAR, or nucleic acid encoding more than one non-identical CAR.

15. The virus-specific immune cell according to any one of claims 12 to 14, wherein the target antigen other than CD30 is a cancer cell antigen.

16. The virus-specific immune cell according to any one of claims 12 to 15, wherein the target antigen other than CD30 is selected from CD19, CD20, CD22, ROR1R, CD4, CD7, CD38, BCMA, Mesothelin, EGFR, GPC3, MUC1, HER2, GD2, CEA, EpCAM, LeY and PSCA.

17. The virus-specific immune cell according to any one of claims 12 to 16, wherein the target antigen other than CD30 is CD19.

18. The virus-specific immune cell according to any one of claims 1 to 17, wherein the virus-specific immune cell is a virus-specific T cell.

19. The virus-specific immune cell according to any one of claims 1 to 18, wherein the virus-specific immune cell is specific for Epstein-Barr virus (EBV).

20. A method for producing a virus-specific immune cell, comprising: modifying a virus-specific immune cell to comprise a chimeric antigen receptor (CAR) or nucleic acid encoding a CAR, wherein the CAR comprises: (i) an antigen-binding domain which binds specifically to CD30, (ii) a transmembrane domain, and (iii) a signalling domain, wherein the signalling domain comprises: (a) an amino acid sequence derived from the intracellular domain of CD28, and (b) an amino acid sequence comprising an immunoreceptor tyrosine-based activation motif (ITAM).

21. The method according to claim 20, wherein the signalling domain comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:26.

22. The method according to claim 20 or claim 21, wherein the transmembrane domain is derived from the transmembrane domain of CD28.

23. The method according to any one of claims 20 to 22, wherein the transmembrane domain comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:20.

24. The method according to any one of claims 20 to 23, wherein the antigen-binding domain comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:14, and an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:15.

25. The method according to any one of claims 20 to 24, wherein the antigen-binding domain comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:18.

26. The method according to any one of claims 20 to 25, wherein the signalling domain comprises: (a) an amino acid sequence derived from the intracellular domain of CD3′.

27. The method according to any one of claims 20 to 26, wherein the signalling domain comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:25.

28. The method according to any one of claims 20 to 27, wherein the CAR additionally comprises a hinge region provided between the antigen-binding domain and the transmembrane domain.

29. The method according to any one of claims 20 to 28, wherein the hinge region comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:33.

30. The method according to any one of claims 20 to 29, wherein the CAR comprises an amino acid sequence having at least 80% amino acid sequence identity to SEQ ID NO:35 or 36.

31. The method according to any one of claims 20 to 30, wherein the virus-specific immune cell comprises a CAR comprising an antigen-binding domain which binds specifically to a target antigen other than CD30, or nucleic acid encoding a CAR comprising an antigen-binding domain which binds specifically to a target antigen other than CD30.

32. A method for producing a virus-specific immune cell, comprising: modifying a virus-specific immune cell to comprise a chimeric antigen receptor (CAR) or nucleic acid encoding a CAR, wherein the CAR comprises: (i) an antigen-binding domain which binds specifically to CD30, (ii) a transmembrane domain, and (iii) a signalling domain comprising an immunoreceptor tyrosine-based activation motif (ITAM); wherein the virus-specific immune cell comprises a CAR comprising an antigen-binding domain which binds specifically to a target antigen other than CD30, or nucleic acid encoding a CAR comprising an antigen-binding domain which binds specifically to a target antigen other than CD30.

33. The method according to any one of claims 20 to 32, wherein the method comprises: modifying a virus-specific immune cell to comprise a chimeric antigen receptor (CAR) or nucleic acid encoding a CAR, wherein the CAR comprises an antigen-binding domain which binds specifically to a target antigen other than CD30.

34. The method according to any one of claims 31 to 33, wherein the virus-specific immune cell comprises more than one non-identical CAR, or nucleic acid encoding more than one non-identical CAR.

35. The method according to any one of claims 31 to 34, wherein the target antigen other than CD30 is a cancer cell antigen.

36. The method according to any one of claims 31 to 35, wherein the target antigen other than CD30 is selected from CD19, CD20, CD22, ROR1R, CD4, CD7, CD38, BCMA, Mesothelin, EGFR, GPC3, MUC1, HER2, GD2, CEA, EpCAM, LeY and PSCA.

37. The method according to any one of claims 31 to 36, wherein the target antigen other than CD30 is CD19.

38. The method according to any one of claims 20 to 38, wherein the virus-specific immune cell is a virus-specific T cell.

39. The method according to any one of claims 20 to 39, wherein the virus-specific immune cell is specific for Epstein-Barr virus (EBV).

40. A virus-specific immune cell obtained or obtainable by the method according to any one of claims 20 to 39.

41. A pharmaceutical composition comprising a virus-specific immune cell according to any one of claims 1 to 19 or claim 40 and a pharmaceutically acceptable carrier, adjuvant, excipient or diluent.

42. A virus-specific immune cell according to any one of claims 1 to 19 or claim 40, or a pharmaceutical composition according to claim 41, for use in a method of medical treatment or prophylaxis.

Description

BRIEF DESCRIPTION OF THE FIGURES

[0617] Embodiments and experiments illustrating the principles of the invention will now be discussed with reference to the accompanying figures.

[0618] FIG. 1. Scatterplots showing expression of HLA-A2 and CD3 by cells obtained following 7 days culture of: non-transduced EBVSTs derived from a HLA-A2-positive subject (upper left pane) or CD30-CAR construct-transduced EBVSTs derived from a HLA-A2-positive subject (upper right panel); or following 7 days co-culture of alloreactive T cells derived from a HLA-A2-negative subject and non-transduced EBVSTs derived from a HLA-A2-positive subject (bottom left pane), or CD30-CAR construct-transduced EBVSTs derived from a HLA-A2-positive subject (bottom right pane).

[0619] FIGS. 2A and 2B. Bar charts showing the cell counts for (2A) EBVSTs (i.e. CD3+, HLA-A2-positive) and (2B) alloreactive T cells (i.e. CD3+, HLA-A2-negative) cells after 7 days.

[0620] FIG. 3. Scatterplots showing expression of HLA-A2 and CD71 in cells obtained following 7 days in coculture comprising HLA-A2-positive PBMCs and non-transduced (NT; upper left panel), CD30-CAR construct-transduced (CD30.CAR; upper right panel), CD19-CAR construct-transduced (CD19.CAR: lower left panel), or CD30-CAR and CD19-CAR construct-transduced (CD30+CD19.CAR; lower right panel) EBVSTs derived from a HLA-A2-negative subject.

[0621] FIG. 4. Graph showing proliferation of CD30.CAR EBVSTs prepared from blood samples taken from 4 representative donors. The graph shows cumulative fold expansion of the cells grown in culture.

[0622] FIGS. 5A and 5B. Graphs showing cytotoxicity of CD30.CAR EBVSTs to (5A) CD30-negative BJAB Burkitt Lymphoma cells and (5B) CD30-positive HDLM2 Hodgkin Lymphoma cells, as determined by .sup.51Cr release assay, following co-culture of CD30.CAR EBVSTs (effector) and .sup.51Cr-labelled target cells (target) at the indicated ratios.

[0623] FIGS. 6A and 6B. Graphs showing reactivity of CD30.CAR EBVSTs prepared from blood samples taken from 4 representative donors to EBV antigens, as determined by ELISpot analysis. Cells were stimulated with peptides of EBV latent antigens (Latent), peptides of EBV lytic antigens (Lytic) or were not stimulated with antigens (Negative), and the number of spot-forming units per 5×10.sup.4 cells was determined. (6A) shows the reactivity of EBVSTs not transduced with retrovirus encoding CD30.CAR. (6B) shows the reactivity of CD30.CAR EBVSTs (transduced with retrovirus encoding CD30.CAR).

[0624] FIG. 7. Representative images showing the results of PET scans of patient #1 performed prior to infusion of CD30.CAR EBVSTs, and 6 weeks post-infusion.

[0625] FIG. 8. Representative images showing the results of PET and CT scans of patient #2 performed prior to infusion of CD30.CAR EBVSTs, and 6 weeks post-infusion.

[0626] FIG. 9. Table showing vector copy number in peripheral blood cells as determined by qRT-PCR, within blood samples obtained prior to infusion of CD30.CAR EBVSTs (pre), and at the indicated period post-infusion.

[0627] FIG. 10. Bar chart showing the results of analysis of specificity of cells for different antigens within the peripheral blood of patient #1, prior to lymphodepletion (pre-LD), and at the indicated period post-infusion of CD30.CAR EBVSTs, as determined by ELISpot analysis. PBMCs isolated from blood samples at the indicated time points were stimulated with peptides of EBV latent antigens (Latent), peptides of EBV lytic antigens (Lytic), peptides of antigens for other viruses (Other Viruses), peptides of tumor-associated antigens (TAA) antigens, or were not stimulated antigens (No pepmix), and the number of spot-forming units per 3×10.sup.5 cells was determined.

EXAMPLES

[0628] In the following Examples, the inventors describe the generation of CD30.CAR-expressing EBVSTs their effector activity against cancer cells and their resistance to allorejection.

Example 1: Generation of Retroviruses Encoding CAR Constructs

[0629]

TABLE-US-00002 Amino acid sequence of Construct name CAR domains encoded CAR [1] CD30-CAR HRS3 scFv/hIgG1 hinge/hIgG1 SEQ ID NO: 35 Fc/CD28TMD/CD28 ICD/CD3ζ ICD [2] CD19-CAR FMC63 scFv/IgG hinge/CD28 TMD SEQ ID NO: 52 v2/4-1BB ICD/CD3ζ ICD

[0630] Retrovirus encoding the CD30.CAR construct was prepared by cloning cDNA encoding the CAR into the pSFG-TGFbDNRII retroviral backbone (ATUM, Newark, Calif.).

[0631] The plasmid carrying the CD30.CAR sequence, pSFG_CD30CAR, was transfected into HEK 293 Vec-RD114 cells using polyethylenimine (PEI). Cell culture supernatant from the transfected cells was then used to transduce HEK 293Vec-Galv cells (BioVec Pharma, Quebec, Canada) at a density of 5×10.sup.5 cells/well of a 6-well plate.

[0632] The 293Vec-Galv_CD30-CAR cells were trypsinized, and the cells were resuspended in a 15 ml tube at a concentration of 2×10.sup.6 cells/ml. Two series of dilutions were made, and 1.65 ml of the final cell suspension was diluted and mixed with 220 ml of DMEM+10% FCS. Two hundred μl of this suspension was transferred to wells of a 96-well plate, resulting in 30 cells per plate. The best performing clone was then selected and used to generate retrovirus-containing supernatant. The retrovirus-containing supernatant was subsequently collected, filtered and stored at −80° C. until use.

[0633] Retrovirus encoding the CD19.CAR construct was produced by cloning DNA encoding the CD19.CAR was cloned into the pSFG retroviral backbone. The plasmid carrying the CD19.CAR sequence, 85bCD19C, was used to transfect HEK 293 Vec-RD114 cells using polyethylenimine (PEI). The retrovirus-containing the supernatant was subsequently collected, filtered and stored at −80° C. until use.

Example 2: Generation of CAR-Expressing EBV-Specific T Cells

[0634] Peripheral blood mononuclear cells (PBMCs) were isolated from blood samples obtained from healthy donors or lymphoma patients according to the standard Ficoll-Paque density gradient centrifugation method.

[0635] Generation of ATCs

[0636] Anti-CD3 (clone OKT3) and anti-CD28 agonist antibodies were coated onto wells of tissue culture plates by addition of 0.5 ml of 1:1000 dilution of 1 mg/ml antibodies, and incubation for 2-4 hr at 37° C., or at 4° C. overnight. 1×10.sup.6 PBMCs (in 2 ml of medium per well) were stimulated by culture on the anti-CD3/CD28 agonist antibody-coated plates in cell culture medium (containing 44.5% Advanced RPMI medium, 44.5% Click's medium, 10% FBS and 1% GlutaMax). The cells were maintained at 37° C. in a 5% CO.sub.2 atmosphere. The next day, 1 ml of the cell culture medium was replaced with fresh cell culture medium containing 20 ng/ml IL-7 and 20 ng/ml IL-15. To maintain ATCs in culture, every 2-4 days, cell culture medium and cytokines were replenished as needed or ATCs were harvested and re-plated in fresh cell culture medium with cytokines. ATCs were harvested and used in experiments for re-stimulation with EBVSTs between days 7-10.

[0637] Universal LCLs

[0638] LCLs lacking surface expression of HLA class I and HLA class II (i.e. HLA-negative LCLs) were obtained by targeted knockout of genes encoding HLA class I and HLA class II molecules in cells of a lymphoblastoid cell line prepared by EBV-transformation of B cells. The HLA-negative cells were further modified to knockout genes necessary for EBV replication. The resulting cells obtained by the methods are referred to herein as universal LCLs (uLCLs).

[0639] Expansion and Transduction of EBV-Specific T Cells (EBVSTs)

[0640] PBMCs from a healthy donor were depleted of CD45RA-expressing cells by magnetic cell separation using CD45RA MACS microbeads (Miltenyi Biotec). EBV-specific T cells were expanded by stimulating 2×10.sup.6 CD45RA-depleted PBMCs (in 2 ml of medium per well) with EBNA1 pepmix (JPT Cat. No. PM-EBV-EBNA1), LMP1 pepmix (JPT Cat. No. PM-EBV-LMP1) and LMP2 pepmix (JPT Cat. No. PM-EBV-LMP2) obtained from JPT Technologies (overlapping 15mer amino acid peptide libraries overlapping by 11 amino acids, spanning the full amino acid sequence of the relevant antigen), in cell culture medium containing 44.5-47% Advanced RPMI, 44.5-47% Click's medium, 10% FBS or 5% growth factor-rich additive and 1% GlutaMax, supplemented with IL-7 (10 ng/ml) and IL-15 (10 ng/ml). EBVSTs were maintained at 37° C. in a 5% CO.sub.2 atmosphere.

[0641] After 4-6 days, EBVSTs were transduced with CAR-encoding retroviruses described in Example 1 as follows.

[0642] Retrovirus-containing supernatants (0.5-1 ml per well) were added to non-tissue culture treated 24-well plates pre-coated with RetroNectin (Takara). After centrifugation of the plate at 2000×g for 60-90 min, retroviral supernatants were removed, and the cells were re-plated at 0.25-0.5×10.sup.6 cells per well.

[0643] After 8-10 days of culture, cells were re-stimulated by co-culture with irradiated, peptide-pulsed autologous activated T cells (ATCs) in the presence of uLCLs. Briefly, 2×10.sup.6 ATCs were incubated with pepmixes (10 ng pepmix mixture per 1×10.sup.6 ATCs) at 37° C. for 30 min in CTL medium, and subsequently irradiated at 30Gy and harvested. The peptide-pulsed ATCs were then mixed with the cells in culture and uLCLs (irradiated at 100Gy), in CTL medium containing IL-7 (10 ng/ml) and IL-15 (100 ng/ml), at a ratio of responder cells:peptide-pulsed ATCs:irradiated uLCLs of 1:1:5. Specifically, 1×10.sup.5 responder cells, 1×10.sup.5 peptide-pulsed ATCs and 0.5×10.sup.6 irradiated uLCLs were cultured in 2 mL CTL medium in wells of a 24 well tissue culture plate.

[0644] To maintain EBVSTs in culture, every 2-4 days, cell culture medium and cytokines were replenished as needed or EBVSTs were harvested and re-plated in fresh cell culture medium with cytokines. EBVSTs were harvested and used in mixed lymphocyte reactions (MLR) assays between days 15-20.

Example 3: Evaluation of the Ability of CD30-Specific CAR to Eliminate Alloreactive T Cells and Protect Allogeneic VSTs from Rejection

[0645] The inventors investigated the effect of CD30.CAR expression on the ability of VSTs to resist allorejection in vitro.

[0646] Generation of Primed Alloreactive T Cells

[0647] 1-2×10.sup.6 PBMCs (per well) from the same healthy donor used to generate the EBVSTs were irradiated at 30 Gray and co-cultured with 1×10.sup.6 PBMCs (per well) from a mismatched donor (with different expression of HLA-A2), in cell culture medium containing 44.5% Advanced RPMI, 44.5% Click's medium, 10% serum, and 1% GlutaMax, supplemented with IL-7 (10 ng/ml) and IL-15 (10 ng/ml). Primed Alloreactive T cells expanded from the PBMCs of the mismatched donor were re-stimulated by plating 0.5×10.sup.6 cells (in 2 ml of cell culture medium) on anti-CD3/CD28 agonist antibody-coated plates on day 6-10. To maintain alloreactive T cells in culture, every 2-4 days, cell culture medium and cytokines were replenished as needed, or alloreactive T cells were harvested and re-plated in fresh cell culture medium with cytokines. Alloreactive T cells were harvested and used in mixed lymphocyte reaction (MLR) assays with EBVSTs between days 13-17.

[0648] To assess allorejection in vitro 0.2×10.sup.4 PBMCs alloreactive T cells from a HLA-A2-negative subject were co-cultured in a mixed lymphocyte reaction (MLR) assay with: [0649] (i) 0.2×10.sup.4 EBVSTs generated from the PBMCs of the HLA-A2-positive subject that was used to prime the alloreactive T cells, or [0650] (ii) 0.2×10.sup.4 EBVSTs generated from the PBMCs of the HLA-A2-positive subject that was used to prime the alloreactive T cells, additionally transduced with construct encoding the CD30-specific CAR.

[0651] Human IL-7 (10 ng/ml) and IL-15 (10 ng/ml) were added to the MLR assay.

[0652] Flow cytometric analysis was performed after 7 days, and absolute cell numbers were determined using counting beads. T cells derived from the different subjects could be identified in the population obtained following co-culture based on expression of HLA-A2. The Gallios Flow Cytometer (Beckman Coulter) was used to acquire events, and Kaluza Analysis Software (Beckman Coulter) was used for data analysis and graphical representation.

[0653] As shown in FIG. 1, the number of non-transduced (NT) EBVSTs derived from the HLA-A2-positive subject was greatly reduced after 7 days co-culture with alloreactive T cells derived from the HLA-A2-negative subject (lower left panel), as compared to when they were cultured in the absence of alloreactive T cells (upper left panel). By contrast, the number of CD30.CAR EBVSTs was increased after 7 days co-culture with alloreactive T cells (lower right panel), as compared to when they were cultured in the absence of alloreactive T cells (upper right panel).

[0654] FIG. 2 shows quantification of the flow cytometry data. The non-transduced EBVSTs (NT) were mostly eliminated in the presence of alloreactive T cells, whereas CD30.CAR-expressing EBVSTs were resistant to elimination by alloreactive T cells (FIG. 2A). In addition, quantification of the alloreactive T cell population (CD3+, HLA-A2-negative) revealed that CD30.CAR EBVSTs reduced the number of alloreactive T cells relative to the non-transduced EBVST condition (FIG. 2B).

[0655] Thus EBVSTs expressing CD30.CAR were shown to have the ability to reduce the number of alloreactive T cells, and to be protected against allorejection.

Example 4: Characterisation of EBV-Specific T Cells Expressing a CD19-Specific CAR and a CD30-Specific CAR

[0656] The inventors produced and characterised virus-specific T cells engineered to express both a CD19.CAR and a CD30.CAR, and examined whether they could eliminate alloreactive T cells in a mixed lymphocyte reaction.

[0657] Briefly, a population of 1×10.sup.5 PBMCs from a HLA-A2-positive subject depleted of CD19 and CD56 expressing cells was co-cultured in a mixed lymphocyte reaction (MLR) assay with: [0658] (i) 0.1×10.sup.5 EBVSTs generated from PBMCs of a HLA-A2-negative subject, or [0659] (ii) 0.1×10.sup.5 EBVSTs generated from PBMCs of a HLA-A2-negative subject, additionally transduced with construct encoding (a) the CD30.CAR, (b) the CD19.CAR, or (c) both the CD30.CAR and the CD19.CAR (CD30+CD19.CAR).

[0660] Human IL-2 was added to the MLR assay at 20 IU/ml.

[0661] As shown in FIG. 3, both the CD30.CAR EBVSTs (upper right panel) and the CD30+CD19.CAR EBVSTs (lower right panel) greatly reduced the proportion of (and thus avoided rejection by) HLA-A2+ alloreactive T cells (distinguished by the activation marker CD71) by day 7, as compared to non-transduced (NT) EBVSTs (upper left panel) and CD19.CAR EBVSTs (lower left panel).

[0662] The inventors thus provide a novel approach to generating an “off-the-shelf” CAR T cell specific for a given target antigen using EBVSTs transduced with both a CAR specific for the target antigen (CD19 in the present example) and a CD30-specific CAR. The ability of such dual CAR-EBVSTs to eliminate alloreactive T cells in vitro, suggests they may be able to avoid rejection and persist long-term in allogeneic recipients in vivo.

Example 5: Treatment of Cancer Using CD30.CAR EBVSTs

5.1 PRODUCTION AND CHARACTERISATION OF CD30.CAR EBVSTS PRODUCED FROM HEALTH DONOR SUBJECTS

[0663] CD30.CAR EBVSTs were manufactured in a GMP facility. Approximately 250 to 400 mL of blood was collected from seven healthy, blood-bank approved donors after obtaining informed consent and in accordance with the guidelines established by the Declaration of Helsinki.

[0664] Peripheral blood mononuclear cells (PBMCs) were isolated from blood by density gradient centrifugation. PBMCs were depleted of CD45RA-expressing cells by magnetic cell separation using a clinical grade anti-CD45RA antibody conjugated to magnetic beads, and using and Miltenyi depletion columns (Miltenyi Biotec, Bergisch Gladbach, Germany).

[0665] 1.5-2.5×10.sup.7 PBMCs depleted of CD45RA-positive cells were seeded in 30 ml culture medium containing 47.5% Advanced RPMI, 47.5% Click's (EHAA) medium (Irvine Scientific), 2 mM L-glutamine (Thermo Fisher Scientific) and 5% Human Platelet Lysate (HPL; Sexton Biotechnologies), supplemented with IL-7 (10 ng/ml) and IL-15 (10 ng/ml) in G-Rex10 vessels, and activated by stimulation with overlapping peptide libraries (pepmixes) comprising 15mer amino acids overlapping by 11 amino acids, and spanning the entire protein sequences of the relevant antigens. Pepmixes corresponding to EBNA1, LMP1, LMP2, BARF1, BZLF1, BRLF1, BMLF1, BMRF1, BMRF2, BALF2, BNLF2a and BNLF2b were obtained from JPT Technologies (Berlin, Germany). Stimulations employed 5 ng of pepmix for each antigen per 1×100 cells to be stimulated (i.e. for stimulations performed using 2×10.sup.7 PBMCs depleted of CD45RA-positive cells, 100 ng of each pepmix was used). Stimulation cultures were maintained at 37° C. in a 5% CO.sub.2 atmosphere.

[0666] After 4-6 days, EBVSTs produced by the stimulation cultures described in the preceding paragraph were transduced with the CAR-encoding retroviruses described in Example 1, as follows. 2 ml of retrovirus-containing supernatant was mixed with 150 μg Vectofusin-1 in a volume of 2 ml, giving a final volume of 4 ml, and incubated at room temperature for 5-30 min. The retrovirus:Vectofusin-1 mixture was then added to 7-10×10.sup.6 cells in 8.5 ml culture medium (described in the preceding paragraph), in T75 vessels. Cultures were maintained at 37° C. in a 5% CO.sub.2 atmosphere.

[0667] Between days 8 and 10 of culture, 1-2×10.sup.7 CD30.CAR EBVSTs CD30.CAR EBVSTs produced by transduction as described in the preceding paragraph were transferred to G-Rex100 vessels, and re-stimulated by co-culture with irradiated (at 100 gray) uLCLs (described in Example 2), at a ratio of CD30.CAR EBVSTs to irradiated uLCLs ranging from 1:2 to 1:5 (typically around 1:3). ULCLs express EBV antigens and CD30, as well as other costimulatory molecules, and therefore provide CD30.CAR EBVSTs with antigen stimulation and costimulation, inducing robust proliferation of CD30.CAR EBVSTs without loss of EBV specificity.

[0668] Re-stimulation cultures were established in 200 ml culture medium (described in paragraph 3 of section 5.1), and additional culture medium was added as required. 7 to 12 days later, CD30.CAR EBVSTs were harvested and cryopreserved for subsequent infusion.

[0669] CD30.CAR EBVSTs prepared from 4 representative healthy donor subjects were evaluated for their ability to proliferate in vitro, cytotoxicity against CD30-expressing and CD30-negative cancer cell lines in vitro, and in order to determine specificity for different EBV antigens.

[0670] Analysis of CD30.CAR EBVST Proliferation

[0671] Proliferation of CD30.CAR EBVSTs was determined by counting the number of cells using a hemocytometer at various time points during culture (Days 0, 6, 10, 17 18 and 19) during culture, and cumulative fold expansion was calculated.

[0672] FIG. 4 shows that CD30.CAR EBVSTs produced from the 4 different healthy donor subjects expanded well in in vitro culture, sufficient to attain therapeutic doses of CD30.CAR EBVSTs within ˜17-20 days. The expanded cells expressed the CD30.CAR on 77% to 99% of cells (data not shown).

[0673] Analysis of CD30.CAR EBVST Cytotoxicity

[0674] The cytotoxic specificity of the CD30.CAR EBVSTs was measured using a chromium-51 (.sup.51Cr) release assay. Briefly, target cells, either CD30-negative BJAB Burkitt lymphoma cells or CD30-positive HDLM2 Hodgkin lymphoma cells were incubated with .sup.51Cr for one hour. Non-transduced EBVSTs or CD30.CAR-transduced EBVSTs were used as effectors and were incubated with targets at effector-to-target ratios of 40:1, 20:1, 10:1, 5:1 and 2.5:1 in wells of 96-well plates. After 4-6 hours of incubation, coculture supernatants were harvested, and .sup.51Cr release was detected with a gamma counter. The percentage of specific lysis was determined from the mean of triplicates using the following formula: [(experimental release−spontaneous release)/(maximum-release−spontaneous release)]×100.

[0675] FIG. 5 shows that the CD30.CAR EBVSTs were substantially non-cytotoxic to cells of the CD30-negative Burkitt lymphoma BJAB cell line, but displayed high cytotoxicity to cells of the CD30-positive Hodgkin lymphoma HDLM2 cell line.

[0676] Analysis of Reactivity of CD30.CAR EBVSTs to EBV Antigens

[0677] IFN-γ ELISpot analysis was performed to evaluate the responses of CD30.CAR EBVSTs prepared from four different healthy donor subjects to stimulation with EBV antigens.

[0678] IFN-γ production was measured in response to stimulation with pepmixes (obtained from JPT Technologies, Berlin, Germany) for EBV latent cycle antigens (EBNA1, LMP1, LMP2 and BARF1) and EBV lytic cycle antigens (BZLF1, BRLF1, BMLF1, BMRF1, BMRF2, BALF2, BNLF2a and BNLF2b). Briefly, CD30.CAR EBVSTs were plated at 5×10.sup.4 cells/well in duplicate in wells of 96-well MultiScreen plates (MilliporeSigma). Stimulations were performed using a total of 0.1 μg peptide per well. After 16-20 hours of incubation at 37° C. in 5% CO.sub.2, the plates were developed for IFN-γ+ spots and sent to ZellNet Consulting (Fort Lee, N.J.) for quantification. The frequency of antigen specific responses are expressed as spot forming units (SFU) per 5×10.sup.4 cells.

[0679] FIG. 6 shows that CD30.CAR EBVSTs produced from the 4 different healthy donor subjects retained their specificity for EBV antigens.

[0680] All four CD30.CAR EBVSTs lines passed the functional release criteria of having producing greater than 100 IFN spot-forming units (SFU) per 10.sup.5 cells in response to stimulation with both latent and lytic EBV antigens, and greater than 20% specific cytolysis against the CD30-positive Hodgkin lymphoma cell line, HDLM2, at an effector to target ratio of 20:1.

5.2 ADMINISTRATION OF CD30.CAR EBVSTS AS ALLOGENEIC ADOPTIVE CELL THERAPY FOR CD30+ LYMPHOMA

[0681] Patients aged 12-75 years having CD30+ refractory or relapsed Hodgkin lymphoma, Non-Hodgkin lymphoma, ALK-positive anaplastic T cell lymphoma, ALK-negative anaplastic T cell lymphoma or other peripheral T-cell lymphoma were eligible for treatment in this study.

[0682] Patients received three daily doses of cyclophosphamide (Cy: 500 mg/m.sup.2/day) together with fludarabine (Flu: 30 mg/m.sup.2/day) to induce lymphopenia, completed at least 48 hours before CD30.CAR EBVST cell infusion, but no later than 2 weeks prior to infusion.

[0683] On Day 0 of study, patients received their planned single dose of allogeneic CD30.CAR EBVSTs by intravenous infusion over approximately 1 to 10 minutes, in a volume of 1 to 50 ml. Patients were administered with CD30.CAR EBVSTs having the best HLA class I and class II match.

[0684] A total of five patients were administered allogeneic CD30.CAR EBVST cells in the present study. Three patients received dose level 1 (DL1), of 4×10.sup.7 CD30.CAR EBVST cells. Two patients received dose level 2 (DL2), of 1×10.sup.8 CD30.CAR EBVST cells.

[0685] Monitoring was undertaken according to institutional standards for administration of blood products, with the exception that the injection was given by a physician. Patients were monitored for at least 3 hours post infusion. Patients were assessed for adverse events, including changes in clinical status and laboratory data. In particular, patients were evaluated for correlates of cytokine release syndrome (CRS) and neurotoxicity, which have been observed in some CAR-T cell immunotherapies.

[0686] Blood samples were collected from patients at the following time points: pre study, 3-4 hours post infusion, 1, 2, 3, 4, and 6 weeks and 3 months post day 0 cell infusion. Samples were analysed in order to assess persistence and efficacy of CD30.CAR EBVSTs.

[0687] None of the patients experienced dose-limiting toxicities, and no cytokine release syndrome (CRS) or graft-vs-host disease (GVHD) of any grade was observed.

[0688] Clinical Responses in Patients Administered Allogeneic CD30.CAR EBVSTs

[0689] Diagnostic imaging was performed to document measurable disease and response to therapy (through PET scans, CT scans, MRI and nuclear imaging) pre-infusion and at 6-8 weeks following day 0 infusion.

[0690] Patient #1 was injected intravenously with 11.9 mCi of FDG in the left antecubital fossa (blood glucose level at the time of injection was 99 mg/dL). PET and CT images were obtained from the midcalvarium to proximal femora, and the images were subsequently fused, with multiplanar reconstruction in the axial, coronal and sagittal planes along with three-dimensional reconstructions.

[0691] Patient #2 was injected intravenously with 7.29 mCi of FDG (blood glucose level at the time of injection was 99 mg/dL). Approximately 60 min later, images from the skull base to the proximal thighs were acquired using a PET-CT scanner utilizing CT attenuation correction techniques. CT slices were obtained using the low-dose technique, and multiplanar reformatted images were obtained.

[0692] FIGS. 7 and 8 show clinical responses in two patients treated with CD30.CAR EBVSTs. Images for patient #1 show resolution of several areas of disease and images for patient #2 show a marked reduction of disease, indicative of therapeutic efficacy for treatment with allogeneic CD30.CAR EBVSTs in these patients.

[0693] Analysis of CD30.CAR Vector Copy Number Post-Administration

[0694] Integrated genome of the retrovirus encoding the CD30.CAR was quantified by real-time qPCR. PBMCs were isolated from peripheral blood samples taken from patients at several time points (Pre-lymphodepletion, 3 hrs, Week 1, Week 2, Week 3, Week 4, Week 6, and Month 3). After extracting DNA from PBMCs with the QIAamp DNA Blood Mini Kit (Qiagen) in accordance with the manufacturer's instructions, we amplified the DNA with primers and probes (Applied Biosystems) complementary to specific sequences within the retroviral vector. A standard curve was established using serial dilutions of the plasmid encoding the transgene. Amplifications were performed using the ABI7900HF Real-Time PCR System (Applied Biosystems) according to the manufacturer's instructions.

[0695] FIG. 9 shows vector copy number of the CD30.CAR transgene for patient #1 and patient #2, and suggest that CD30.CAR EBVSTs do not expand in vivo, and quickly become undetectable in the peripheral blood in these patients.

[0696] Analysis of Epitope Spreading in Patients Administered Allogeneic CD30.CAR EBVSTs

[0697] In order to evaluate epitope spreading, immune cells were collected from patient #1 at several time points, and stimulated with tumor-associated antigens to determine their reactivity before and after infusion of allogeneic CD30.CAR EBVSTs.

[0698] PBMCs were isolated from peripheral blood samples taken from patients at several time points (Pre-lymphodepletion, 3 hrs, Week 1, Week 2, Week 3, Week 4, Week 6, and Month 3) and used in an ELISpot assay performed essentially as described in Example 5.1 above, with the exception that PBMCs were plated at 3×10.sup.5 per well, and that in addition to evaluation of EBV latent and lytic antigens, two additional groups of antigens were used to stimulate PBMCs; (1) a pool of pepmixes of antigens from “Other Viruses” (adenovirus proteins Hexon and Penton, and CMV protein PP65), and (2) a pool of pepmixes corresponding to the tumor-associated antigens (TAA) MAGE-A4, NY-ESO, PRAME, SSX2, and Survivin.

[0699] FIG. 10 shows that Patient #1 did not have responses to the tumor-associated antigens at any time point, suggesting that there was no epitope spreading in patient #1. This result suggests that treatment with allogeneic CD30.CAR EBVSTs did not sensitize the patient's immunes system toward these other tumor antigens.

5.3 CONCLUSIONS

[0700] The inventors have shown that CD30.CAR EBVSTs produced from healthy donor subjects can be expanded to sufficient numbers and preserve the function of both their TCR and the CD30.CAR, with retention of EBV specificity and the ability to eliminate CD30-positive tumor cells, in accordance with their use as an off-the-shelf treatment for patients with CD30+ cancer.

[0701] CD30.CAR EBVSTs were found to be safe, and to display therapeutic efficacy against CD30-positive lymphoma in vivo in allogeneic recipients. Clinical responses were observed despite the limited persistence of CAR-expressing cells in the peripheral blood, and in the absence of evidence of epitope spreading to other tumor-associated antigens.