The safety and clinical effects of administering a multiantigen-targeted T cell therapy to patients with multiple myeloma
SCIENCE TRANSLATIONAL MEDICINE
Authors: Lulla, Premal D.; Tzannou, Ifigeneia; Vasileiou, Spyridoula; Carrum, George; Ramos, Carlos A.; Kamble, Rammurti; Wang, Tao; Wu, Mengfen; Bilgi, Mrinalini; Gee, Adrian P.; Mukhi, Shivani; Chung, Betty; Wang, Linghua; Watanabe, Ayumi; Kuvalekar, Manik; Jeong, Mira; Li, Yumei; Ketkar, Shamika; French-Kim, Matthew; Grilley, Bambi; Brenner, Malcolm K.; Heslop, Helen E.; Vera, Juan F.; Leen, Ann M.
Abstract
Multiple myeloma (MM) is an almost always incurable malignancy of plasma cells. Despite the advent of new therapies, most patients eventually relapse or become treatment-refractory. Consequently, therapies with nonoverlapping mechanisms of action that are nontoxic and provide long-term benefit to patients with MM are greatly needed. To this end, we clinically tested an autologous multitumor-associated antigen (mTAA)-specific T cell product for the treatment of patients with high-risk, relapsed or refractory MM. In this study, we expanded polyclonal T cells from 23 patients with MM. T cells whose native T cell receptors were reactive toward five myeloma-expressed target TAAs (PRAME, SSX2, MAGEA4, Survivin, and NY-ESO-1) were enriched ex vivo. To date, we have administered escalating doses of these nonengineered mTAA-specific T cells (0.5 x 10(7) to 2 x 10(7) cells/m(2)) to 21 patients with MM, 9 of whom were at high risk of relapse after a median of 3 lines of prior therapy and 12 with active, relapsed or refractory disease after a median of 3.5 prior lines. The cells were well tolerated, with only two transient, grade III infusion-related adverse events. Furthermore, patients with active relapsed or refractory myeloma enjoyed a longer than expected progression-free survival and responders included three patients who achieved objective responses concomitant with detection of functional TAA-reactive T cell clonotypes derived from the infused mTAA product.
Cancer testis antigen expression in testicular germ cell tumorigenesis
MODERN PATHOLOGY
Authors: Bode, Peter K.; Thielken, Andrea; Brandt, Simone; Barghorn, Andre; Lohe, Bernd; Knuth, Alexander; Moch, Holger
Abstract
Cancer testis antigens are encoded by germ line-associated genes that are present in normal germ cells of testis and ovary but not in differentiated tissues. Their expression in various human cancer types has been interpreted as 're-expression' or as intratumoral progenitor cell signature. Cancer testis antigen expression patterns have not yet been studied in germ cell tumorigenesis with specific emphasis on intratubular germ cell neoplasia unclassified as a precursor lesion for testicular germ cell tumors. Immunohistochemistry was used to study MAGEA3, MAGEA4, MAGEC1, GAGE1 and CTAG1B expression in 325 primary testicular germ cell tumors, including 94 mixed germ cell tumors. Seminomatous and non-seminomatous components were separately arranged and evaluated on tissue microarrays. Spermatogonia in the normal testis were positive, whereas intratubular germ cell neoplasia unclassified was negative for all five CT antigens. Cancer testis antigen expression was only found in 3% (CTAG1B), 10% (GAGE1, MAGEA4), 33% (MAGEA3) and 40% (MAGEC1) of classic seminoma but not in nonseminomatous testicular germ cell tumors. In contrast, all spermatocytic seminomas were positive for cancer testis antigens. These data are consistent with a different cell origin in spermatocytic seminoma compared with classic seminoma and support a progression model with loss of cancer testis antigens in early tumorigenesis of testicular germ cell tumors and later re-expression in a subset of seminomas.