Immunotherapeutic targeting of gangliosides in Ewing Sarcoma

项目摘要 尤文肉瘤（EWS）是儿童和年轻人中第二常见的累及骨的肿瘤， 在大多数转移性或复发性疾病患者中是致命的。活下来的病人， 他们接受的毒性治疗的影响。目前还没有新的、成功的靶向药物被开发出来， 我们治疗EWS已经将近四十年了，我们已经达到了加强化疗的极限 治疗。新的治疗方法是必要的，以防止复发和治愈更多的患者。 免疫疗法已经改变了许多成人实体瘤的治疗前景，但尚未介导 为患有EWS的儿童提供大量福利。嵌合抗原受体（CAR）T细胞已经彻底改变了免疫系统。 治疗儿童复发性白血病和淋巴瘤。最近，我们发现靶向GD2的CAR T细胞， 一种在许多儿科癌症表面表达的糖，在患有不可治愈的脑肿瘤的儿童中活跃。 该提案的重点是将GD2 CAR T细胞应用于EWS。由于GD2在细胞表面不均一表达， EWS，我们将探索多种机制来有效地将CAR T细胞应用于这种疾病：1）靶向密切相关的 相关神经节苷脂，当GD2低时高度表达，和2）利用表观遗传抑制剂， 增加GD2，使CAR T细胞能够更好地识别肿瘤细胞。在目标1中，我们将定义表达式 神经节苷脂及其相关合酶在患者组织上的表达，并针对替代物测试汽车 神经节苷脂在目标2中，我们将利用表观遗传抑制剂在体外和体内增加EWS肿瘤上的GD2。在 目标3，我们将测试CAR T细胞和表观遗传抑制剂的组合方法。成功完成 这些研究将为患有尤文肉瘤的儿童提供新的治疗选择。

Project Summary Ewing sarcoma (EWS) is the second most common tumor involving bone in children and young adults and is fatal in most patients with metastatic or relapsed disease. Patients who survive are left with a lifetime of late effects from the toxic therapy they receive. There have been no new, successful targeted drugs developed to treat EWS for nearly forty years, and we have reached the limit on how much we can intensify chemotherapy treatments. New therapeutic approaches are necessary to prevent relapse and cure more patients. Immunotherapy has altered the treatment landscape for many adult solid tumors but has not yet mediated substantial benefit for children with EWS. Chimeric antigen receptor (CAR) T cells have revolutionized the treatment of children with relapsed leukemia and lymphoma. Recently, we found that CAR T cells targeting GD2, a sugar expressed on the surface of many pediatric cancers, are active in children with incurable brain tumors. This proposal focuses on applying GD2 CAR T cells to EWS. Because GD2 is heterogeneously expressed on EWS, we will explore multiple mechanisms to effectively apply CAR T cells in this disease: 1) targeting a closely related ganglioside that is highly expressed when GD2 is low and 2) utilizing epigenetic inhibitors to significantly increase GD2, making CAR T cells better able to recognize tumor cells. In Aim 1, we will define the expression of gangliosides and their related synthase enzymes on patient tissues and test CARs against an alternative ganglioside. In Aim 2, we will utilize epigenetic inhibitors to increase GD2 on EWS tumors in vitro and in vivo. In Aim 3, we will test combinatorial approaches of CAR T cells and epigenetic inhibitors. Successful completion of these studies will result in new therapeutic options for children with Ewing sarcoma.