Inducing immunogenic cell death in immuno-oncological therapies

Immunotherapy has revolutionized cancer treatment and substantially improved patient outcomes with respect to multiple types of tumors.However,most patients cannot benefit from such therapies,mainly due to the intrinsic low immunogenicity of cancer cells(CCs)that allows them to escape recognition by immune cells of the body.Immunogenic cell death(ICD),which is a form of regulated cell death,engages in a complex dialogue between dying CCs and immune cells in the tumor microenvironment(TME),ultimately evoking the damage-associated molecular pattern(DAMP)signals to activate tumor-specific immunity.The ICD inducers mediate the death of CCs and improve both antigenicity and adjuvanticity.At the same time,they reprogram TME with a“cold-warmhot”immune status,ultimately amplifying and sustaining dendritic cell-and T cell-dependent innate sensing as well as the antitumor immune responses.In this review,we discuss how to stimulate ICD based upon the biological properties of CCs that have evolved under diverse stress conditions.Additionally,we highlight how this dynamic interaction contributes to priming tumor immunogenicity,thereby boosting anticancer immune responses.We believe that a deep understanding of these ICD processes will provide a framework for evaluating its vital role in cancer immunotherapy.

Characteristics of premanufacture CD8^(+) T cells determine CAR-T efficacy in patients with diffuse large B-cell lymphoma

Although chimeric antigen receptor(CAR)T cells have become an important treatment option for patients with relapsed/refractory B-cell malignancies,more than 60%of patients with diffuse large B-cell lymphoma(DLBCL)treated with CAR-T cell therapies fail to achieve a durable response.To reveal changes in CAR-T cell therapy and identify response biomarkers,we conducted a retrospective analysis of pre-manufacture source T cells and CAR-T cell products and their association with outcome in 58 patients with r/rDLBCL who received tandem CD19/CD20 CAR-T cell therapy.We performed bulk RNA-Seq,single-cell RNA-Seq,and paired T cell receptor sequencing on CAR-T cell products and pre-manufacture T cells from DLBCL patients.We note that a CD8+stem cell-like memory T cell population with a higher proportion and enhanced activating capacity of the CAR-T cell products was key to achieving durable clinical response.By analysing autologously-derived,pre-manufacture T cells,our data suggest that heterogeneity in the cellular and molecular features of pre-manufacture T cells contribute to the variation in efficacy after CAR-T cell therapy in DLBCL.The differences in anti-tumour efficacy of CAR-T cells among patients with different clinical outcomes appear to be due to the loss of CCR7 gene expression,coupled with increased expression of activation-and inhibitor-related genes in the CD8+naïve-T cell populations among the apheresis T cells from patients with a poor molecular response.These findings significantly advance our understanding of the underlying molecular determinants of pre-manufacture T cell function.

Optimized collaboration of the first and third signals endows robust activity to T cells within the immunocompetent tumor microenvironment

CAR T-cell therapy has shown remarkable potential in the treatment of hematologic malignancies,and these successes have greatly motivated research on treatment of solid tumors.Although numerous clinical trials have been actively carried out,exciting clinical responses are still sporadic and may be are transient for patients with solid tumors[1].

CART trials are going ahead

For a long time,unresectable tumors were mainly controlled by chemotherapy,radiation therapy or kinase inhibitors,with which complete and durable remission was infrequent despite great advances achieved.Until recently,together with checkpoint inhibitors,chimeric antigen receptor modified T(CART)therapies have made immunotherapy percolated into the mainstream of cancer treatment due to astonishing clinical results.

Clinical development of CAR T cell therapy in China:2020 update

Chimeric antigen receptor(CAR)T-cell therapy has achieved significant success in the treatment of hematological malignancies.In recent years,fast-growing CAR T clinical trials have actively explored their potential application scenarios.According to the data from the clinicaltrials.gov website,China became the country with the most registered CAR T trials in September 2017.As of June 30,2020,the number of registered CAR T trials in China has reached 357.In addition,as many as 150 other CAR T trials have been registered on ChiCTR.Although CAR T therapy is flourishing in China,there are still some problems that cannot be ignored.In this review,we aim to systematically summarize the clinical practice of CAR T-cell therapy in China.This review will provide an informative reference for colleagues in the field,and a better understanding of the history and current situation will help us more reasonably conduct research and promote cooperation.

The model of cytokine release syndrome in CAR T-cell treatment for B-cell non-Hodgkin lymphoma

Chimeric antigen receptor T(CAR T)cell therapy has demonstrated efficacy in the treatment of haematologic malignancies.However,the accompanying adverse events,the most common of which is cytokine release syndrome(CRS),substantially limit its wide application.Due to its unique physiological characteristics,CRS in CAR T-cell treatment for B-cell non-Hodgkin lymphoma(BNHL)may exhibit some special features.Although existing guidelines had greatly promoted the recognition and management of CRS,many recommendations are not fully applicable to B-NHL.Therefore,it is imperative to identify responses that are specific to CRS observed following CAR T treatment for B-NHL.Based on underlying biological processes and known pathophysiological mechanisms,we tentatively propose a new model to illustrate the occurrence and evolution of CAR T-cell-therapy-related CRS in BNHL.In this model,tumour burden and bone marrow suppression are considered determinants of CRS.Novel phenomena after CAR T-cell infusion(such as local inflammatory response)are further identified.The proposed model will help us better understand the basic biology of CRS and recognize and manage it more rationally.

Adaptive T cell immunotherapy in cancer

Impaired tumor-specific effector T cells contribute to tumor progression and unfavorable clinical outcomes. As a compensatoryT cell-dependent cancer immunoediting strategy, adoptive T cell therapy (ACT) has achieved encouraging therapeutic results,and this strategy is now on the center stage of cancer treatment and research. ACT involves the ex vivo stimulation and expansionof tumor-infiltrating lymphocytes (TILs) with inherent tumor reactivity or T cells that have been genetically modified to expressthe cognate chimeric antigen receptor or T cell receptor (CAR/TCR), followed by the passive transfer of these cells into alymphodepleted host. Primed T cells must provide highly efficient and long-lasting immune defense against transformed cellsduring ACT. Anin-depth understanding of the basic mechanisms of these living drugs can help us improve upon currentstrategies and design better next-generation T cell-based immunotherapies. From this perspective, we provide an overview ofcurrent developments in different ACT strategies, with a focus on frontier clinical trials that offer a proof of principle. Meanwhile,insights into the determinants of ACT are discussed, which will lead to more rational, potent and widespread applicationsin the future.

Identification of NOXA as a pivotal regulator of resistance to CAR T-cell therapy in B-cell malignancies

Despite the remarkable success of chimeric antigen receptor(CAR)T-cell therapy for treating hematologic malignancies,resistance and recurrence still occur,while the markers or mechanisms underlying this resistance remain poorly understood.Here,via an unbiased genome-wide CRISPR/Cas9 screening,we identified loss of NOXA,a B-cell lymphoma 2(BCL2)family protein in B-cell malignancies,as a pivotal regulator of resistance to CAR T-cell therapy by impairing apoptosis of tumor cells both in vitro and in vivo.Notably,low NOXA expression in tumor samples was correlated with worse survival in a tandem CD19/20 CAR T clinical trial in relapsed/refractory B-cell lymphoma.

Spotlight on chimeric antigen receptor engineered T cell research and clinical trials in China

T cell mediated adoptive immune response has been characterized as the key to anti-tumor immunity. Scientists around the world including in China, have been trying to harness the power of T cells against tumors for decades. Recently, the biosynthetic chimeric antigen receptor engineered T cell(CAR-T) strategy was developed and exhibited encouraging clinical efficacy, especially in hematological malignancies. Chimeric antigen receptor research reports began in 2009 in China according to our Pub Med search results. Clinical trials have been ongoing in China since 2013 according to the trial registrations on clinicaltrials.gov.. After years of assiduous efforts, research and clinical scientists in China have made their own achievements in the CAR-T therapy field. In this review, we aim to highlight CAR-T research and clinical trials in China, to provide an informative reference for colleagues in the field.