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Allo-defensive, multiplex base-edited, anti-CD38 CAR T cells for 'off-the-shelf' immunotherapy

Preece, Roland; Gough, Oliver; Joshi, Akshay; Kadirkamanathan, Renuka; Cudworth, Eamonn; Kallon, Delordson; Georgiadis, Christos; (2025) Allo-defensive, multiplex base-edited, anti-CD38 CAR T cells for 'off-the-shelf' immunotherapy. Haematologica 10.3324/haematol.2025.289016. (In press). Green open access

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Abstract

Chimeric antigen receptor (CAR) T cell therapies are being widely investigated in both autologous and allogeneic settings, with gene editing providing new strategies to address barriers to mismatched cell therapies. Currently 'universal' donor derived T cell therapies require intensive lymphodepletion and are still prone to hostmediated rejection. CD38, a transmembrane glycoprotein involved in cell activation and bioenergetics, is a promising immunotherapy target for haematological malignancies. Disruption of CD38 expression using base editing prevented fratricide between T cells expressing anti-CD38 CAR (CAR38). Additional base editing enabled generation of 'universal' donor CAR38-T cells, devoid of endogenous TCRαβ and Human Leukocyte Antigen (HLA) molecules after disruption of T Cell Receptor Beta Constant (TRBC), Beta-2 microglobulin (B2M), and Regulatory Factor X5 (RFX5). Removal of cell surface HLA expression enabled evasion of anti-HLA antibodies in sera from sensitised donors and reduced allo-stimulation in mixed lymphocyte cultures (MLCs), while TCRαβ disruption prevented allo-reactivity. In MLCs, CAR38 expression enabled potent 'allo-defense' activity against CD38+ alloreactive cells. Multiplex-base-edited CAR38-T cells exhibited antigen-specific antileukemic activity against human B, T, and myeloid malignancies and inhibited disease progression in humanised murine xenograft models. CAR38-T cells offer a potent 'off-the-shelf' strategy against CD38+ haematological malignancies and longlived plasma cells which can be associated with autoantibody production.

Type: Article
Title: Allo-defensive, multiplex base-edited, anti-CD38 CAR T cells for 'off-the-shelf' immunotherapy
Location: Italy
Open access status: An open access version is available from UCL Discovery
DOI: 10.3324/haematol.2025.289016
Publisher version: https://doi.org/10.3324/haematol.2025.289016
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10219767
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