Elimination of CD19-positive lymphoid malignancies by CD19-CAR expressing NK cells
Provided herein are compositions of NK-92® cells that express a CD19 CAR, CD16 and IL2, and the method of using these cells to and treat cancer in a patient.
1. A recombinant isolated natural killer (NK)-92 cell expressing an anti-cluster of differentiation 19 (CD19) chimeric antigen receptor (CAR) and a fragment crystallizable (Fc) receptor, wherein the anti-CD19 CAR has the amino acid sequence of SEQ ID NO:12, wherein the NK-92 cell has an accession number selected from the group consisting of CRL-2407, PTA 6670, CRL-2408, CRL-2409, PTA-6967, PTA-8837 and PTA-8836.
2. The recombinant isolated NK-92 cell of claim 1 , wherein the NK-92 cell comprises a multi-cistronic construct and wherein the multi-cistronic construct encodes the anti-CD19 CAR and the Fc receptor, and wherein the anti-CD19 CAR has an single-chain variable fragment (scFv) ectodomain that is encoded by SEQ ID NO:9.
3. The recombinant isolated NK-92 cell of claim 1 , wherein the Fc receptor is a cluster of differentiation 16 (CD16).
4. The recombinant isolated NK-92 cell of claim 1 , wherein the Fc receptor comprises SEQ ID NO: 2.
5. The recombinant isolated NK-92 cell of claim 2 , wherein the multi-cistronic transgene further comprises a sequence that encodes an interleukin-2 (IL-2) or a variant thereof.
6. The recombinant isolated NK-92 cell of claim 5 , wherein the IL-2 variant is endoplasmic reticulum-directed (er)IL-2.
7. The recombinant isolated NK-92 cell of claim 6 , wherein the coding sequences for one or more of the anti-CD19 CAR, the Fc receptor, or erIL-2 or erIL-15 are codon-optimized for expression in a human system.
8. The recombinant isolated NK-92 cell of claim 1 , wherein NK-92 cell is capable of killing a CD19-expressing cell.
9. The recombinant isolated NK-92 cell of claim 8 , wherein the CD19-expressing cell is a tumor cell.
10. The recombinant isolated NK-92 cell of claim 9 , wherein the tumor cell is a SUP-B15 cell.
11. The recombinant isolated NK-92 cell of claim 1 , wherein the NK-92 cell is transfected with a nucleic acid having a sequence of SEQ ID NO:13 that encodes the anti-CD19 CAR and the Fc receptor.
12. The recombinant isolated NK-92 cell of claim 2 , wherein the multi-cistronic transgene further comprises a sequence that encodes an interleukin-15 (IL-15) or a variant thereof.
13. The recombinant isolated NK-92 cell of claim 12 , wherein the variant thereof is erIL-15.
14. The recombinant isolated NK-92 cell of claim 1 , wherein the NK-92 cell comprises a sequence encoding a self-cleaving peptide, wherein the sequence is located between the anti-CD19 CAR and the Fc receptor, and wherein the sequence allows equimolar expression of the anti-CD19 CAR and the Fc receptor.
15. The recombinant isolated NK-92 cell of claim 1 , wherein the NK-92 cell comprises an internal ribsosomal entry sequence (IRES) between a sequence encoding the Fc receptor and the sequence encoding IL-2 or a variant thereof.
16. The recombinant isolated NK-92 cell of claim 1 , wherein a direct cytotoxicity of the NK-92 cell on CD19-expressing cells is 70-100% when the effector to target ratio is 10.
17. The recombinant isolated NK-92 cell of claim 1 , wherein an antibody-dependent cell-mediated cytotoxicity (ADCC) activity of the NK-92 cell is at 30%-90% when the effector to target ratio is 10.
18. The recombinant isolated NK-92 cell of claim 1 , wherein the anti-CD19 CAR comprises a cytoplasmic signaling domain.
19. The recombinant isolated NK-92 cell of claim 18 , wherein the cytoplasmic signaling domain comprises at last one of Fc epsilon receptor gamma (FcεRIγ) and a cluster of differentiation 3 (CD3) zeta signaling domain.
20. A method of treating a cancer in a subject, comprising administering to the subject a therapeutically effective amount of a composition to the subject, the composition comprising a plurality of recombinant isolated NK-92 cells according to claim 1 , and where the cancer has cancer cells expressing CD19.
21. The method of claim 20 , wherein about 1×108 to about 1×1011 modified cells per m2 of body surface area of the subject are administered to the subject.
22. The method of claim 20 , wherein the cancer is a leukemia or a lymphoma.
23. The method of claim 20 , wherein the cancer is one or more of B-cell malignancy, B-cell malignancy post-HSCT, CLL, B-ALL, acute lymphoblastic leukemia (ALL), B-lineage lymphoid malignancy post-UCBT, chronic lymphocytic leukemia (CLL), B-Non-Hodgkin's Lymphoma (B-NHL), ALL post-HSCT; lymphoma, refractory follicular lymphoma, or Lymphoblastic leukemia.
24. The method of claim 23 , wherein the B-cell malignancy is a Mantle cell lymphoma.
25. The method of claim 20 , wherein the plurality of the NK-92 cells are administered intravenously and/or intratumorally.