Invited Speakers Eradicate Cancer 2018

Immunotherapy with antigen specific T cells (#29)

Helen Heslop

Cellular immunotherapies have immense potential as they can specifically target tumor antigens through native or artificial receptors. We have evaluated expanded T cells recognizing tumor antigens though their native receptor to target viruses such as EBV or HPV expressed on tumor cells with encouraging response rates when using either autologous cells or donor derived cells post transplant. More recent studies have infused closely matched third-party virus-specific T cells and reported encouraging response rates between 50 and 90%.  As most tumors do not express viral antigens we have also evaluated tumor-associated antigens (TAAs) such as cancer testis antigens (CTAs) MAGE, BAGE, GAGE, NY-ESO-1, SSX and PRAME which are expressed by many malignancies but otherwise are found only in germline tissues that are immune privileged and therefore not susceptible to T-cell attack. We have used peptide libraries that can present both HLA-class I- and class II-restricted epitopes to reactivate TAA-specific T cells and to overcome the possibility of tumor escape by targeting multiple epitopes in 5 antigens in clinical trials in lymphoma, myeloma and acute leukemia. Clinical responses have been seen in all studies correlating with the detection of tumor-reactive T cells in patient peripheral blood post-infusion directed against both targeted antigens as well as non-targeted TAAs indicating antigen/epitope spreading. Antigen specific T cells may also be used as target cells for transfer of artificial receptors such as chimeric antigen receptors (CARs).