Chimeric Antigen Receptor (CAR) T cells have demonstrated incredible effectiveness in treating some haematological malignancies1-3, and were recently shown to have the potential to provide long term remission4. However, clinical trial results in glioblastoma; a devastating form of brain cancer, have provided evidence that single agent CAR T therapy is insufficient to mediate long term tumour regression5, 6, attributed mostly to antigen escape, tumour heterogeneity and an immunosuppressive microenvironment. We have developed a novel antigen binding domain (ABD); GCT02 which binds to the glioblastoma-specific mutation EGFRvIII7. The GCT02 CAR was found to secrete generally lower quantities of cytokines compared to a CAR generated with the 2173-EGFRvIII ABD (UPenn/Novartis5) but maintained cytotoxic capacity. In vivo, this CAR mediated the complete and rapid clearance of murine orthotopic brain tumours7.
However, as these single target approaches have shown vulnerability to antigen escape particularly for heterogeneous tumours, smarter engineering of T cells is likely going to be required to enhance overall efficacy. Logic gating technology is one such form of enhanced engineering, allowing delivery of anti-tumour molecules directly into the tumour. Using the Synthetic Notch (SynNotch) AND-gating system8-10, we designed receptors using the GCT02 and 2173 ABDs, and have shown these receptors to be functional in triggering the transcription of a proinflammatory cytokine.
I will also present pilot data which may suggest that factors such as affinity, avidity and ABD which are all known to influence CAR function, may also play a role in influencing SynNotch function.
In summary, we have developed a functional and effective novel CAR, specific for EGFRvIII and repurposed the ABD to a logic gated system. SynNotch circuits may enhance safety via localised mediator release and provides the potential for combination therapies to be delivered at the tumour site, thus enhancing therapeutic efficacy in glioblastoma.