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Longitudinal PET imaging demonstrates biphasic CAR T cell responses in survivors
Yogindra Vedvyas, Enda Shevlin, Marjan Zaman, Irene M. Min, Alejandro Amor-Coarasa, Spencer Park, Susan Park, Keon-Woo Kwon, Turner Smith, Yonghua Luo, Dohyun Kim, Young Kim, Benedict Law, Richard Ting, John Babich, Moonsoo M. Jin
Yogindra Vedvyas, Enda Shevlin, Marjan Zaman, Irene M. Min, Alejandro Amor-Coarasa, Spencer Park, Susan Park, Keon-Woo Kwon, Turner Smith, Yonghua Luo, Dohyun Kim, Young Kim, Benedict Law, Richard Ting, John Babich, Moonsoo M. Jin
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Research Article Immunology Therapeutics

Longitudinal PET imaging demonstrates biphasic CAR T cell responses in survivors

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Abstract

Clinical monitoring of adoptive T cell transfer (ACT) utilizes serial blood analyses to discern T cell activity. While useful, these data are 1-dimensional and lack spatiotemporal information related to treatment efficacy or toxicity. We utilized a human genetic reporter, somatostatin receptor 2 (SSTR2), and PET, to quantitatively and longitudinally visualize whole-body T cell distribution and antitumor dynamics using a clinically approved radiotracer. Initial evaluations determined that SSTR2-expressing T cells were detectable at low densities with high sensitivity and specificity. SSTR2-based PET was applied to ACT of chimeric antigen receptor (CAR) T cells targeting intercellular adhesion molecule-1, which is overexpressed in anaplastic thyroid tumors. Timely CAR T cell infusions resulted in survival of tumor-bearing mice, while later infusions led to uniform death. Real-time PET imaging revealed biphasic T cell expansion and contraction at tumor sites among survivors, with peak tumor burden preceding peak T cell burden by several days. In contrast, nonsurvivors displayed unrelenting increases in tumor and T cell burden, indicating that tumor growth was outpacing T cell killing. Thus, longitudinal PET imaging of SSTR2-positive ACT dynamics enables prognostic, spatiotemporal monitoring with unprecedented clarity and detail to facilitate comprehensive therapy evaluation with potential for clinical translation.

Authors

Yogindra Vedvyas, Enda Shevlin, Marjan Zaman, Irene M. Min, Alejandro Amor-Coarasa, Spencer Park, Susan Park, Keon-Woo Kwon, Turner Smith, Yonghua Luo, Dohyun Kim, Young Kim, Benedict Law, Richard Ting, John Babich, Moonsoo M. Jin

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Figure 3

CAR T cell efficacy against thyroid tumor cells in vitro and in vivo.

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CAR T cell efficacy against thyroid tumor cells in vitro and in vivo.
(A...
(A) Representative histograms showing the level of anti–ICAM-1 antibody binding to ICAM-1–negative HEK 293T, ICAM-1–positive HeLa, and 8505C cells. (B) Schematic of the lentivirus vector encoding SSTR2-R6.5-CAR. CD8α SS (signal sequence); TM, transmembrane; Cyt, cytoplasmic domain. Representative dot plots showing anti-SSTR2 and anti-CAR antibody binding to nontransduced (left) and SSTR2-P2A-R6.5-CAR–transduced (right) primary human T cells. (C) Primary human T cells were transduced separately with individual vectors encoding either SSTR2 or R6.5-CAR. Representative histograms show anti-SSTR2 antibody binding to either R6.5-CAR– or SSTR2-transduced (filled) and nontransduced (open) primary T cells. (D) Effector/target (E:T) assay measuring lysis of target expressing (HeLa and 8505C) or control (HEK 293) cells by CAR T cells at a 2.5:1 E:T ratio. Percentages of live cells were measured by bioluminescence intensity normalized to the levels of target cells incubated with nontransduced T cells. Octreotide (1 μM) was added to SR T cells as indicated (SR+Oct). n = 3–6 from 3 different donor T cells. NT, nontransduced T cells; SS, SSTR2-transduced T cells; RR, R6.5-CAR–transduced T cells; SR, SSTR2-R6.5-CAR–transduced T cells.

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