Driving CARs on the uneven road of antigen heterogeneity in solid tumors

Curr Opin Immunol. 2018 Apr:51:103-110. doi: 10.1016/j.coi.2018.03.002. Epub 2018 Mar 16.

Abstract

Uniform and strong expression of CD19, a cell surface antigen, on cells of B-cell lineage is unique to hematologic malignancies. Tumor-associated antigen (TAA) targets in solid tumors exhibit heterogeneity with regards to intensity and distribution, posing a challenge for chimeric antigen receptor (CAR) T-cell therapy. Novel CAR designs, such as dual TAA-targeted CARs, tandem CARs, and switchable CARs, in conjunction with inhibitory CARs, are being investigated as means to overcome antigen heterogeneity. In addition to heterogeneity in cancer-cell antigen expression, the key determinants for antitumor responses are CAR expression levels and affinity in T cells. Herein, we review CAR T-cell therapy clinical trials for patients with lung or pancreatic cancers, and provide detailed translational strategies to overcome antigen heterogeneity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Animals
  • Antigens, Neoplasm / immunology*
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Immunotherapy, Adoptive
  • Lung Neoplasms / genetics
  • Lung Neoplasms / immunology
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / pathology
  • Lymphocyte Activation
  • Neoplasms / genetics
  • Neoplasms / immunology*
  • Neoplasms / metabolism*
  • Neoplasms / therapy
  • Pancreatic Neoplasms / genetics
  • Pancreatic Neoplasms / immunology
  • Pancreatic Neoplasms / metabolism
  • Pancreatic Neoplasms / pathology
  • Receptors, Antigen, T-Cell / immunology*
  • Receptors, Antigen, T-Cell / metabolism*
  • Receptors, Chimeric Antigen / metabolism
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism*
  • Tumor Escape / immunology

Substances

  • Antigens, Neoplasm
  • Receptors, Antigen, T-Cell
  • Receptors, Chimeric Antigen