Chimeric Antigen Receptor T Cell with an Inducible Caspase-9 Suicide Gene Eradicates Uveal Melanoma Liver Metastases via B7-H3 Targeting

Clin Cancer Res. 2024 Aug 1;30(15):3243-3258. doi: 10.1158/1078-0432.CCR-24-0071.

Abstract

Purpose: Uveal melanoma (UM) is the most common intraocular malignant tumor. Despite successful treatment of the primary tumor, about 50% of patients will recur with systemic diseases for which there are no effective treatment strategies. Here we investigated the preclinical efficacy of a chimeric antigen receptor (CAR) T-cell-based immunotherapy targeting B7-H3.

Experimental design: B7-H3 expression on primary and metastatic human UM samples and cell lines was assessed by RNA sequencing, flow cytometry, and immunohistochemistry. Antitumor activity of CAR T cells targeting B7-H3 was tested in vitro with UM cell lines, patient-derived organotypic tumor spheroids from patients with metastatic UM, and in immunodeficient and humanized murine models.

Results: B7-H3 is expressed at high levels in >95% UM tumor cells in vitro and in vivo. We generated a B7-H3 CAR with an inducible caspase-9 (iCas9) suicide gene controlled by the chemical inducer of dimerization AP1903, which effectively kills UM cells in vitro and eradicates UM liver metastases in murine models. Delivery of iCas9.B7-H3 CAR T cells in experimental models of UM liver metastases demonstrates a durable antitumor response, even upon tumor rechallenge or in the presence of a significant metastatic disease burden. We demonstrate effective iCas9.B7-H3 CAR T-cell elimination in vitro and in vivo in response to AP1903. Our studies demonstrate more effective tumor suppression with iCas9.B7-H3 CAR T cells as compared to a B7-H3-targeted humanized monoclonal antibody.

Conclusions: These studies support a phase I clinical trial with iCas9.B7-H3 CAR T cells to treat patients with metastatic UM.

MeSH terms

  • Animals
  • B7 Antigens* / genetics
  • Caspase 9* / genetics
  • Caspase 9* / metabolism
  • Cell Line, Tumor
  • Genes, Transgenic, Suicide*
  • Humans
  • Immunotherapy, Adoptive* / methods
  • Liver Neoplasms* / genetics
  • Liver Neoplasms* / immunology
  • Liver Neoplasms* / secondary
  • Liver Neoplasms* / therapy
  • Melanoma* / genetics
  • Melanoma* / immunology
  • Melanoma* / pathology
  • Melanoma* / secondary
  • Melanoma* / therapy
  • Mice
  • Receptors, Chimeric Antigen* / genetics
  • Receptors, Chimeric Antigen* / immunology
  • T-Lymphocytes / immunology
  • T-Lymphocytes / metabolism
  • Uveal Neoplasms* / genetics
  • Uveal Neoplasms* / immunology
  • Uveal Neoplasms* / pathology
  • Uveal Neoplasms* / therapy
  • Xenograft Model Antitumor Assays*

Substances

  • B7 Antigens
  • Receptors, Chimeric Antigen
  • CD276 protein, human
  • Caspase 9
  • CASP9 protein, human

Supplementary concepts

  • Uveal melanoma