Quantitative single-cell biomarkers of T-cells to optimize tumor immunotherapy

描述（由申请方提供）：输注抗体、疫苗和细胞的免疫疗法是人类恶性肿瘤的有效治疗方法。通过利用免疫系统的特异性和相关效应子功能识别和消除癌细胞来实现有效的抗肿瘤作用。临床试验已经揭示了基于免疫的疗法的优点，包括（i）确定的作用机制，（ii）确定的特异性和减少的有害脱靶效应，（iii）比常规方法更低的毒性。基于遗传修饰以增强嵌合抗原受体（CAR）表达的T细胞的过继转移的免疫细胞疗法（ACT）在治疗所有其他治疗方法难治的肿瘤的临床试验中显示出相当大的前景。特别是，使用对CD19具有特异性的CAR+ T细胞在常规疗法难治的CD19+慢性淋巴细胞白血病（CLL）患者中表现出显著的抗肿瘤作用。这些试验注入了已经繁殖到临床上足够数量的遗传修饰的T细胞的异质群体。虽然输注T细胞的治疗潜力取决于其持久性，但评估输注T细胞存活的免疫相关研究目前仅限于（i）描述T细胞接种物的整个群体的免疫表型和功能，以及（ii）对输注后回收的T细胞进行免疫表型分析。该拨款申请旨在通过开发用于评估直接从免疫治疗接受者获得（没有体外操作）的少数T细胞（和肿瘤细胞）的表型和功能的统一平台，来调整单细胞成像和检索以告知临床级CD19特异性CAR+ T细胞的效力。我们的目标是使用我们已经开发的高通量单细胞巨噬细胞筛选（SNS）对输注前CAR+ T细胞进行深入的定量功能表征（多重细胞因子分泌、表型、细胞毒性、调节性T细胞的作用、Treg），并将这些数据与输注后从患者回收的T细胞进行比较。这些数据将用于（i）量化输注T细胞的功能和抗肿瘤作用的潜力，以及（ii）改善T细胞的生成，以在下一代临床试验中获得更大的疗效。我们将在特定目标1中验证我们的方法，其中我们将定义临床级CD19特异性CAR+ T细胞的整合功能和分子特征。在具体目标2中，我们将实施我们的方法来量化过继转移细胞的体内持久性。这将验证SNS可以量化临床级T细胞的治疗潜力和下一代临床试验的假设。

DESCRIPTION (provided by applicant): Immunotherapy infusing antibodies, vaccines, and cells is an effective treatment approach for human malignancies. Potent anti-tumor effects are realized by harnessing the specificity and associated effector functions of the immune system to recognize and eliminate cancer cells. Clinical trials have revealed the advantages of immune-based therapies, including (i) defined mechanisms of action, (ii) defined specificity and reduced deleterious off-target effects, (iii) lower toxicities than conventional approaches. Adoptive cell therapy (ACT), based on the adoptive transfer of T cells genetically modified to enforce expression of a chimeric antigen receptor (CAR), has shown considerable promise in clinical trials treating tumors refractory to all other treatment methods. In particular, the use of CAR+ T cells rendered specific for CD19 demonstrated significant anti-tumor effects in patients with CD19+ chronic lymphocytic leukemia (CLL) refractory to conventional therapies. These trials infuse a heterogeneous population of genetically modified T cells which have been propagated to clinically-sufficient numbers. While the therapeutic potential of infused T cells depends on their persistence, immunocorrelative studies evaluating survival of infused T cells are currently limited to (i) describing the immunophenotypes and function of whole populations of the T-cell inoculum and (ii) immunophenotypic analyses on T cells recovered after infusion. This grant application seeks to adapt single- cell imaging and retrieval to inform on the potency of clinical-grade CD19-specific CAR+ T cells by developing a unified platform for assessing both phenotype and function on the few T cells (and tumor cells) directly obtained (without in vitro manipulation) from recipients of immunotherapy. Our objective is to use high throughput single-cell nanowell screening (SNS) that we have developed to undertake an in-depth quantitative functional characterization (multiplexed cytokine secretion, phenotype, cytotoxicity, effect of regulatory T cells, Treg) of pre-infusion CAR+ T cells and compare these data to T cells recovered from the patient, post-infusion. These data will be used to (i) quantify the functionalit of infused T cells and the potential for anti-tumor effects and (ii) improve the generation of T cells for greater efficacy in next-generation clinical trials. We will validate our approach in Specific Aim 1 where we will define the integrated functional and molecular profiles of clinical- grade CD19-specific CAR+ T cells. In Specific Aim 2 we will implement our methodology to quantify the in vivo persistence of adoptively transferred cells. This will test the hypothesis tha SNS can quantify the therapeutic potential of clinical-grade T cells and in the formation of next-generation clinical trials.