Adoptive therapy with TCR gene-engineered T cells provides an attractive and feasible treatment option for cancer patients. Further development of TCR gene therapy requires the implementation of T-cell target epitopes that prevent “on-target” reactivity towards healthy tissues and at the same time direct a clinically effective response towards tumor tissues. Candidate epitopes that meet these criteria are MAGE-C2336-344/HLA-A2 (MC2/A2) and MAGE-A3243-258/HLA-DP4 (MA3/DP4). We molecularly characterized TCRαβ genes of an MC2/A2-specific CD8 and MA3/DP4-specific CD4 T-cell clone derived from melanoma patients who responded clinically to MAGE vaccination. We identified MC2/A2 and MA3/DP4-specific TCR-Vα3/Vβ28 and TCR-Vα38/Vβ2 chains and validated these TCRs in vitro upon gene transfer into primary human T cells. The MC2 and MA3 TCR were surface-expressed and mediated CD8 T-cell functions towards melanoma cell lines and CD4 T-cell functions towards dendritic cells, respectively. We intend to start testing these MAGE-specific TCRs in phase I clinical trial.

Purpose

Immune responses to gene-modified cells are a concern in the field of human gene therapy as they may impede effective treatment. We conducted two clinical trials in which cancer patients were treated with lymphocytes genetically engineered to express murine T cell receptors (mTCR) specific for tumor-associated antigens p53 and gp100.

Experimental Design

Twenty-six patients treated with autologous lymphocytes expressing mTCR had blood and serum samples available for analysis. Patient sera were assayed for development of a humoral immune response. Adoptive cell transfer characteristics were analyzed to identify correlates to immune response.

Results

Six of 26 (23%) patients post-treatment sera exhibited specific binding of human anti-mTCR antibodies to lymphocytes transduced with the mTCR. Antibody development was found in both responding and non-responding patients. Three of these six patients post-treatment sera mediated a 60 – 99% inhibition of mTCR activity as measured by a reduction in antigen-specific IFN-γ release. Detailed analysis of post-treatment serum revealed that antibody binding was beta chain specific in one patient whereas it was alpha chain specific in another.

Conclusions

A subset of patients treated with mTCR engineered T-cells developed antibodies directed to the mTCR variable regions and not to the constant region domains common to all mTCR. Overall, the development of a host immune response was not associated with the level of transduced cell persistence or response to therapy. In summary, patients treated with mTCR can develop an immune response to gene-modified cells in a minority of cases, but this may not affect clinical outcome.