R01CA249062

Understanding and Manipulating Programmed Cell Death (PCD) Pathways to Facilitate Lymphoid Tumor Killing by CAR T Cells - Project Summary

Recent advances using CAR T cells in lymphoid malignancies have made it clear that manipulation of the host immune system can radically alter the course of cancer. Although there have been lifesaving responses in some patients, all too many patients have inadequate responses. Some patients and tumor types have been more amenable to CAR T cell therapies than others, despite similar levels of antigen expression, uniformity, and density.

The exact mechanisms by which CAR T cells induce tumor cell death are unknown and may be due to a combination of multiple T cell effector functions that ultimately result in cell death, potentially by triggering programmed cell death in tumor cells. Our overall hypothesis is that CAR T cells mediate tumor cell death by inducing programmed cell death (PCD) pathways in target cells. A logical corollary of this hypothesis is that one potential mechanism of resistance, which has received scant attention, is genetic or functional resistance to PCD in the target tumor cells.

Furthermore, we hypothesize that the state of PCD constituents in tumor cells confers sensitivity or resistance to T-cell mediated killing, and that this relative resistance can be overcome with drugs that enhance PCD signaling in tumor cells. Finally, because systemically administered drugs that enhance PCD signaling may also affect CAR T cells, we propose genetic engineering approaches to render CAR T cells resistant to candidate PCD-enhancing drugs.

This is a collaborative project between an expert in CAR T cells and immunology and an expert in programmed cell pathways and tumor biology. Together, we aim to:

1. Define the effector functions of T cells that induce tumor cell death (AIM 1).
2. Define the programmed cell death pathways in tumors that confer sensitivity or resistance to CAR T cell mediated killing (AIM 2).
3. Use innovative strategies to enhance CAR T cell killing of tumor cells by manipulating PCD pathways using small molecule drugs in combination with genetic engineering of the CAR T cells.

The General Hospital Corporation

TO DEVELOP THE MEANS TO CURE AS MANY CANCER PATIENTS AS POSSIBLE AND TO CONTROL THE DISEASE IN THOSE PATIENTS WHO ARE NOT CURED. CANCER TREATMENT RESEARCH INCLUDES THE DEVELOPMENT AND EVALUATION OF IMPROVED METHODS OF CANCER TREATMENT THROUGH THE SUPPORT AND PERFORMANCE OF BOTH FUNDAMENTAL AND APPLIED LABORATORY AND CLINICAL RESEARCH. RESEARCH IS SUPPORTED IN THE DISCOVERY, DEVELOPMENT, AND CLINICAL TESTING OF ALL MODES OF THERAPY INCLUDING: SURGERY, RADIOTHERAPY, CHEMOTHERAPY, AND BIOLOGICAL THERAPY INCLUDING MOLECULARLY TARGETED THERAPIES, BOTH INDIVIDUALLY AND IN COMBINATION. IN ADDITION, RESEARCH IS CARRIED OUT IN AREAS OF NUTRITIONAL SUPPORT, STEM CELL AND BONE MARROW TRANSPLANTATION, IMAGE GUIDED THERAPIES AND STUDIES TO REDUCE TOXICITY OF CYTOTOXIC THERAPIES, AND OTHER METHODS OF SUPPORTIVE CARE THAT MAY SUPPLEMENT AND ENHANCE PRIMARY TREATMENT. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.395 - Cancer Treatment Research

National Cancer Institute (NCI) [HHS - NIH]

Massachusetts United States

State-Wide

Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-19-056)

Amendment Since initial award the total obligations have increased 382% from $720,152 to $3,469,484.