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oai:repisalud.isciii.es:20.500.12105/260482025-12-18T12:59:05Zcom_20.500.12105_15322com_20.500.12105_2051com_20.500.12105_2052col_20.500.12105_16961col_20.500.12105_16977col_20.500.12105_19627

00925njm 22002777a 4500 dc Esquinas, Esperanza author Moreno-Sanz, Alvaro author Sandá, Victor author Stodulski-Ciesla, Damian author Borregón, Jennifer author Peña-Blanque, Virginia author Fernández-Calles, Javier author Fernandez-Fuentes, Narcis author Serrano-Lopez, Juana author Juan, Manel author Engel, Pablo author Llamas-Sillero, Pilar author Solán-Blanco, Laura author Martín-Antonio, Beatriz author 2024-12-18 Background: Infusion of T cells modified with a chimeric antigen receptor (CAR) targeting CD19 has achieved exceptional responses in patients with non-Hodgkin's lymphoma (NHL), which led to the approval of CAR targeting CD19 (CART19) (Axi-cel and Liso-cel) as second line of treatment for adult patients with relapsed/refractory NHL. Unfortunately, 60% of patients still relapse after CART19 due to either a loss of expression of the target antigen (CD19) in the tumor cell, observed in 27% of relapsed patients, a limited CAR-T persistence, and additional mechanisms, including the suppression of the tumor microenvironment. Clinic strategies to prevent target antigen loss include sequential treatment with CARs directed at CD20 or CD22, which have caused loss of the second antigen, suggesting targeting other antigens less prone to disappear. CD79b, expressed in NHL, is a target in patients treated with antibody-drug conjugates (ADC). However, the limited efficacy of ADC suggests that a CAR therapy targeting CD79b might improve results. Methods: We designed three new CARs against CD79b termed CAR for Lymphoma (CARLY)1, 2 and 3. We compared their efficacy, phenotype, and inflammatory profiles with CART19 (ARI0001) and CARTBCMA (ARI0002h), which can treat NHL. We also analyzed the target antigen's expression loss (CD79b, CD19, and B-cell maturation antigen(BCMA)). Results: We found that CARLY2 and CARLY3 had high affinity and specificity towards CD79b on B cells. In vitro, all CAR-T cells had similar anti-NHL efficacy, which was retained in an NHL model of CD19- relapse. In vivo, CARLY3 showed the highest efficacy. Analysis of the loss of the target antigen demonstrated that CARLY cells induced CD79b and CD19 downregulation on NHL cells with concomitant trogocytosis of these antigens to T cells, being most notorious in CARLY2, which had the highest affinity towards CD79b and CD19, and supporting the selection of CARLY3 to design a new treatment for patients with NHL. Finally, we created a CAR treatment based on dual targeting of CD79b and BCMA to avoid losing the target antigen. This treatment showed the highest efficacy and did not cause loss of the target antigen. Conclusions: Based on specificity, efficacy, and loss of the target antigen, CARLY3 represents a potential novel CAR treatment for NHL. Esquinas E, Moreno-Sanz A, Sandá V, Stodulski-Ciesla D, Borregón J, Peña-Blanque V, Fernández-Calles J, Fernandez-Fuentes N, Serrano-Lopez J, Juan M, Engel P, Llamas-Sillero P, Solán-Blanco L, Martin-Antonio B. Preclinical development of three novel CARs targeting CD79b for the treatment of non-Hodgkin's lymphoma and characterization of the loss of the target antigen. J Immunother Cancer. 2024 Dec 18;12(12):e009485. 10.1136/jitc-2024-009485 2051-1426 Journal for immunotherapy of cancer 39694704 https://hdl.handle.net/20.500.12105/26048 Chimeric antigen receptor - CAR Lymphoma T cell Preclinical development of three novel CARs targeting CD79b for the treatment of non-Hodgkin's lymphoma and characterization of the loss of the target antigen