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Immunotherapy with gene-modified T cells: limiting side effects provides new challenges

Gene Therapy volume 20, pages 1029–1032 (2013)Cite this article

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Abstract

Genetic tools have been developed to efficiently engineer T-cell specificity and enhance T-cell function. Chimeric antigen receptors (CAR) use the antibody variable segments to direct specificity against cell surface molecules. T-cell receptors (TCR) can redirect T cells to intracellular target proteins, fragments of which are presented in the peptide-binding groove of HLA molecules. A recent clinical trial with CAR-modified T cells redirected against the B-cell lineage antigen CD19 showed dramatic clinical benefit in chronic lymphocytic leukaemia patients. Similarly, impressive clinical responses were seen in melanoma and synovial cell carcinoma with TCR-modified T cells redirected against the melanocyte lineage antigen MART-1 and the testis-cancer antigen NY-ESO-1. However, on and off-target toxicity was associated with most of these clinical responses, and fatal complications have been observed in some patients treated with gene modified T cells. This review will discuss factors that might contribute to toxic side effects of therapy with gene modified T cells, and outline potential strategies to retain anticancer activity while reducing unwanted side effects.

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Acknowledgements

The authors are supported by grants from Leukaemia & Lymphoma Research UK, Medical Research Council, Experimental Cancer Medicine Centre, EU ATTACK and ATTRACT Consortium.

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  1. Department of Immunology, Institute of Immunity and Transplantation, Royal Free Hospital, University College London, London, UK

    H J Stauss & E C Morris

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  1. H J Stauss
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Correspondence to H J Stauss or E C Morris.

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HJS is on the scientific advisory board of Cell Medica.

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Stauss, H., Morris, E. Immunotherapy with gene-modified T cells: limiting side effects provides new challenges. Gene Ther 20, 1029–1032 (2013). https://doi.org/10.1038/gt.2013.34

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