Clin Cancer Res. WebThis page lists cancer drugs approved by the Food and Drug Administration (FDA) for the treatment of solid tumors based on their genetic and molecular features and not on NKp44-NKp44 ligand interactions in the regulation of natural killer cells and other innate lymphoid cells in humans. Despite decades of work, the ontogeny of NK cells in humans is still not fully elucidated. Membrane bound IL-21 based NK cell feeder cells drive robust expansion and metabolic activation of NK cells. Targeting immunosuppressive components in the TME to re-invigorate NK functions is also under investigation. In pre-clinical studies, various BiKEs and TriKEs have been designed to target a number of tumor antigens: CD19, CD20, and CD33 for hematological cancers, HER2, EGFR, and EpCAM for solid tumors [79]. Sakamoto N, et al. The feasibility of utilizing allogeneic NK cells, the established safety profiles, and the fast-acting nature of NK cells largely have led to the emerging effort to develop off-the-shelf NK cell-based cancer immunotherapy. Phase I clinical trial of autologous NK cell therapy using novel expansion method in patients with advanced digestive cancer. Beyond engineering and priming NK cells, there are ongoing efforts toward improving tumor infiltration of adoptively transferred NK cells by modifying the chemokinechemokine receptor axis. 2020;12:324755. Multiple effects of IL-21 on human NK cells in ex vivo expansion. 2009;373(9674):155061. This approval was based on clinical study demonstrating that oNKord improves survival in year 1 of 80% vs. 35% in the control arm. Perform PBMCs apheresis from the patient and isolate NK cells, transfect the NK cells with Claudin6 targeting CAR, amplify the number of transfected NK cells as Distinctly different from T cell receptors, NK cell receptors are germline-encoded and hard-wired receptors without a requirement for V(D)J recombination. J Natl Cancer Inst. Mol Immunol. developed an NK cell recruiting protein-conjugated antibody (NRPbody) containing a mesothelin-specific tumor targeting domain Meso-scFv and the chemokine CXCL16 linked by a furin cleavage sites [90]. The IL-15-based ALT-803 complex enhances FcgammaRIIIa-triggered NK cell responses and in vivo clearance of B cell lymphomas. 2019;145(7):193545. 2000;356(9244):17959. WebFurther pharmacodynamic studies in tumor-free mice revealed superior proliferative and cytotoxic functions on NK cells after RLI treatment compared with IL-15 alone. In allogeneic transfer settings, the concept of KIR and HLA mismatches between donor and recipient was the original strategy aimed at enhancing the activation of donor NK cells to eradicate patients tumor cells. Article Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The trial is Use of chimeric antigen receptor NK-92 cells to target mesothelin in ovarian cancer. Natural killer (NK) cells inhibit systemic metastasis of glioblastoma cells and have therapeutic effects against glioblastomas in the brain. Schnalzger TE. As the activation and expansion methods are improving, it is becoming possible to prepare increasingly higher dosages of NK cells for adoptive transfer from a single-donor phlebotomy. Among these TCR cell co-stimulatory molecules, 4-1BB, DNAM1, 2B4, and NKG2D were also expressed by NK cells as native activating receptors. However, there are many challenges to overcome, such as difficulty to meet clinical-grade ex vivo expansion, limited in vivo persistence, limited infiltration to solid tumors, and tumor editing to evade NK cell activity. WebEnded 2022 with Approximately $475 Million in Cash, Cash Equivalents, and Receivables. 2018;67(4):57587. This method has achieved over 15% of CD34+ hematopoietic progenitors compared to other methods producing only up to 4% of CD34+. Zhang Q, et al. Natural killer cells stimulated with PM21 particles expand and biodistribute in vivo: clinical implications for cancer treatment. Through several preclinical studies, researchers have discovered new guardian immune cells called chimeric antigen receptor (CAR)-modified natural killer (NK) cells, which show cytotoxic activity against various solid tumor types. Wang et al. Glyostems lead candidate NK cell therapy is currently being tested in a phase 1/2a trial for the treatment of the blood cancer acute myeloid leukemia. Sakamoto N, et al. Cytokines in clinical cancer immunotherapy. 2016;5(9):e1219007. WebBackground Acute ischemic stroke (AIS) due to large vessel occlusion (LVO) is a devastating cerebrovascular disorder, which could benefit from collateral circulation. Notably, certain tissues such as the mucosal barriers possess subsets of recently identified innate lymphoid cells (ILCs) that also share canonical markers of NK cells. This property, which is unique among immune cells, and their capacity to enhance antibody and T cell responses support a role for NK cells as anticancer agents. 2012;16(3):56981. OKT3, an anti-CD3 mAb, has been commonly added to the irradiated autologous PBMC feeder, which can promote the expansion of NK cells up to over 1000-fold [4, 142,143,144]. Current challenges Article Wang W, et al. Spanholtz J, et al. While the majority of investigation of ex vivo NK priming strategies rely on one or more cytokines, some studies indicate that cytokine supplement is not as critical for NK cell priming. 2015;6:368. Cord blood NK cells engineered to express IL-15 and a CD19-targeted CAR show long-term persistence and potent antitumor activity. Blood. NK Cell-mediated antibody-dependent cellular cytotoxicity in cancer immunotherapy. Clinical-grade generation of active NK cells from cord blood hematopoietic progenitor cells for immunotherapy using a closed-system culture process. Ojo EO, et al. Immunity. NKG2D and DNAM-1 activating receptors and their ligands in NK-T cell interactions: role in the NK cell-mediated negative regulation of T cell responses. Exposure of NK to unmodified NK cell-sensitive leukemia cells (K562) stimulates expansion and short-term proliferation [133]. It has been shown that freshly isolated, resting NK cells are generally less lytic as compared to NK cells primed via various strategies [82]. https://doi.org/10.1186/s13045-020-01014-w, DOI: https://doi.org/10.1186/s13045-020-01014-w. WebChimeric antigen receptor T cells therapy (CAR-T therapy) is a class of ACT therapy. A model for the differentiation of human natural killer cells. The signaling domains of CAR-NK cells are very similar to those in CAR-T cells, typically composed of the fusion of CD3 with one or two TCR co-stimulatory molecule (s), such as CD28, 4-1BB, 2B4, DNAM1, and NKG2D. 2015;17(11):158293. Mesothelin is a tumor differentiation antigen that is highly overexpressed in several human cancers including malignant mesothelioma, pancreatic, ovarian, and lung adenocarcinoma [91]. Additional markers such as lack of c-kit can be used to distinguish human NK (c-kit-) from ILC3s (c-kit+) [14]. statement and Sarvaria A, et al. Donor-derived natural killer cells infused after human leukocyte antigen-haploidentical hematopoietic cell transplantation: a dose-escalation study. NK cells originate from CD34+ hematopoietic stem cells. 2015;15:1011. Cancers (Basel), 2020; 12(6). CAS Chang YH, et al. Studies on the in vitro activation of Leu-11+ granular lymphocytes with a natural killer-sensitive tumor cell, K562. CD19-CAR engineered NK-92 cells are sufficient to overcome NK cell resistance in B-cell malignancies. 2019;19(1):80. In response to the mounting data on this emerging therapy, the present paper provides a thorough review of the technical issues, molecular background and current preclinical and clinical data associated with CAR-NK cell applications in cancer treatment. The exhausted T cells or NK cells in the tumor microenvironment exhibit imbalanced Based on the pre-clinical findings, CTV-1 lysate-primed human NK cells (CNDO-109-NK cells) derived from HLA-haploidentical donors were evaluated for safety in a phase I clinical trial (NCT01520558) in high-risk AML patients with AML after first complete remission [89]. Gras Navarro A, et al. Conventional NK cells are short-lived innate lymphocytes that lack antigen specificity. Expression of IL-15 in NK cells results in rapid enrichment and selective cytotoxicity of gene-modified effectors that carry a tumor-specific antigen receptor. Gauthier, L., et al. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Genetically engineered CAR NK cells display selective cytotoxicity against FLT3-positive B-ALL and inhibit in vivo leukemia growth. Oyer JL, et al. 2016;22(3):596608. Membrane-bound IL-21 promotes sustained ex vivo proliferation of human natural killer cells. Immunotherapy. 2012;209(13):235165. Herberman RB, Nunn ME, Lavrin DH. Characterization of the maturation stage of NK cells demonstrated that RLI favored accumulation of CD11b+ CD27high KLRG1+ Natural killer (NK) cells can swiftly kill multiple adjacent cells if these show surface markers associated with oncogenic transformation. An increasing number of in vitro and in vivo studies have examined the activity of CAR-NK cells against solid tumors, with most preclinical data being available Moreover, highly cytotoxic NK cells derived using such method are capable of producing endogenous cytokines that improve their survival, proliferation, and function [132]. NK cells in the tumor microenvironment Conventional roles of NK cells in immunity Detection of aberrant cells by NK cells is determined by the intergradation of Article Mehta RS, Shpall EJ, Rezvani K. Cord blood as a source of natural killer cells. Generation of BiKEs and TriKEs to improve NK cell-mediated targeting of tumor cells. 2017;8:87. Lister J, et al. NK cells possess advantageous characteristics, including non-MHC-restricted recognition, ability to infiltrate Cichocki F, et al. Guerra N, et al. Kiessling R, Klein E, Wigzell H. Natural" killer cells in the mouse. Clinical grade purification and expansion of NK cell products for an optimized manufacturing protocol. Cytometry B Clin Cytom. 2013;13(2):1459. 2006;107(1):15966. J Hematol Oncol 14, 7 (2021). Ruggeri L, et al. volume14, Articlenumber:7 (2021) 2013;2013(1):23446. 2016; 8(357): p. 357ra123. 2017;28(10):88696. Lu C, et al. 2017;18(9):100415. Rosario M, et al. PubMed Central Methods Mol Biol. Furthermore, IL-2, streptococcus A group, and zoledronate have all been approved for human use. The combination of IL-2/IL-15/IL-21 can support up to eightfold expansion of NK cells [121]. Oberschmidt O, et al. 2009;69(9):40107. NK cells expressing a chimeric activating receptor eliminate MDSCs and rescue impaired CAR-T cell activity against solid tumors. In the xenograft models, NK cell infusion combined with intraperitoneal injection of the NRPbody significantly reduced tumor burden as compared to NK infusion combined with the non-cleavable control [90]. There are numerous ongoing clinical trials exploring the safety and efficacy of NK-based therapy in combination with other modalities. Parodi M, et al. One approach to address the safety concern is the use of lysed cell product. More recent evidence had indicated that NK cells can also develop and mature at secondary lymphoid organs, including tonsils, spleen, and lymph nodes [19]. Expression of chimeric receptor CD4zeta by natural killer cells derived from human pluripotent stem cells improves in vitro activity but does not enhance suppression of HIV infection in vivo. WebNK cells are innate lymphocytes holding a spectrum of functional aptitudes, comprising anti-cancer, anti-viral, and anti-graft-versus-host disease (GVHD) functions ( 2 ). However, the exhaustion of T cells or NK cells can lead to the failure of tumor control and limit the complete response and overall efficacy of cancer immunotherapy against solid tumors. Successful adoptive transfer and in vivo expansion of human haploidentical NK cells in patients with cancer. With the understanding of how NK cells are activated, the initial NK cell-based therapy was pioneered in the clinical setting of hematopoietic stem cell transplants (HSCTs) whereby NK cells were shown to have the capacity to exert a graft versus leukemia effect. First-in-man clinical trial of CAR NK-92 cells: safety test of CD33-CAR NK-92 cells in patients with relapsed and refractory acute myeloid leukemia. NK cell progenitors progress through distinct developmental stages and gradually acquire the expression of surface receptors that define NK cell identity such as NK1.1 and CD56 and/or regulate their effector functions such as CD16 and NKp46 [19]. CAR-engineered iPSC-NK cells already have demonstrated effectiveness in targeting human tumors in preclinical studies [41]. Cytotherapy. Retargeting of natural killer-cell cytolytic activity to ErbB2-expressing cancer cells results in efficient and selective tumor cell destruction. The interim results showed that 8 out of 11 patients had an objective response to treatment without development of major toxic effects [150]. All authors gave consent for publication of the manuscript. The conventional linear model suggests that mature NK cells arise from common lymphoid progenitors (CLPs) by progressing through a linear continuum [24]. However, CAR-T therapy has two major challenges: (i) requirement of a substantiate length of time to generate a therapeutic dose of autologous CAR-T cells which limits its feasibility to treat patients with rapidly progressing diseases; (ii) difficulty to obtain sufficient number of autologous T cells for CAR-T cell generation from heavily pre-treated and often lymphopenic cancer patients [37]. Despite the immunosuppressive environment of solid tumors, NK cell activity/infiltration has been correlated with improved prognoses in humans. Uherek C, et al. NK cell-based cancer immunotherapy: from basic biology to clinical development, https://doi.org/10.1186/s13045-020-01014-w, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, Emerging agents and regimens for cancer therapy 2020. 2017;8(1):67. WebFirst described in the 1970s, NK cells have been a promising tool in the field of adoptive immunotherapy ( 34 ). Blood. demonstrated that antibody-mediated blockade of CD73 significantly enhanced the anti-tumor activities of NKG2D-enginneered CAR-NK92 in vitro and in vivo, with improved tumor infiltration by CAR-NK cells in vivo [43]. 2012;14(7):83040. Typically, the differentiation was induced in embryoid bodies or by OP9 mouse stroma co-culture [111]. 2016;18(1):8090. Notably, many tissue-resident NK subsets are now shown to be phenotypically and functionally distinct from conventional peripheral blood NK cells [20]. 2015;220(7):87688. The exciting results from Liu et al. Blood Transfus. 2023 BioMed Central Ltd unless otherwise stated. Sakamoto Table 6 summarizes updated clinical trials of NK cell-based therapy for all solid tumors. PLoS ONE. Sci Rep. 2019;9(1):14916. Synergistic effects of cabozantinib and EGFR-specific CAR-NK-92 cells in renal cell carcinoma. CAR NK therapy offers experimental treatment option for blood cancers BY Devon Carter Natural killer cells or NK cells are part of our immune system. Chimeric antigen receptor (CAR) is an engineered synthetic receptor of CAR-T, which give T cells the ability to recognize tumor antigens in a human leukocyte antigen-independent (HLA-independent) manner and enables them to recognize more extensive target Topfer K, et al. Szmania S, et al. 2011;6(6):e20740. WebThese antibodies are currently used in clinical trials in the treatment of both hematological and solid tumors. Tumor-primed human natural killer cells lyse NK-resistant tumor targets: evidence of a two-stage process in resting NK cell activation. 2008;28(4):57180. 2015;38(5):197210. Skeate R, et al. A novel method to expand large numbers of CD56(+) natural killer cells from a minute fraction of selectively accessed cryopreserved cord blood for immunotherapy after transplantation. The ability of Natural Killer (NK) cells to kill tumor targets has been extensively studied in various hematological malignancies. The anti-CD3 mAb presumably activates T cells in feeder to secret cytokines which subsequently create a milieu favorable for NK cell expansion [145]. NK cells are mounted with a repertoire of inhibitory and activating surface receptors (Table 1) [25,26,27,28,29]. Block copolymer-boron cluster conjugate for effective boron neutron capture therapy of solid tumors. One major immunosuppressive factor in the TME is the metabolite adenosine, whose production is catalyzed in a sequential manner by the ectoenzymes CD39 and CD73 [43]. Targeted drugs are the preferred recommendations for the systemic treatment of hepatocellular carcinoma. Table 5 summarizes the clinical trials of NK cell-based therapy for hematological malignancies to date. Recent observations show that HMGB1 is a potent driver 2002;11(4):6517. The success has encouraged many ongoing clinical investigations of NK cell-based cancer therapy alone or in combination with other regimes. Cytokines are the critical components of NK maintenance system and activation as discussed earlier. Ex vivo-expanded highly purified natural killer cells in combination with temozolomide induce antitumor effects in human glioblastoma cells in vitro. The subjects of the study were patients with high-risk solid tumors, including Ewing Sarcoma, Neuroblastoma, Rhabdomyosarcoma, Osteosarcoma, and CNS tumors. Journal of Hematology & Oncology Due to relatively unsophisticated cues for activation, NK cell has gained significant attention in the field of cancer immunotherapy. 2017;9(6):1796812. IL-21 enhances natural killer cell response to cetuximab-coated pancreatic tumor cells. Oncotarget. This TriKE design (GTB-3550) is currently in clinical trial for treating high-risk hematological malignancies (NCT03214666). Anti-tumor activities of adoptively transferred NK cells in vivo have been demonstrated as well in pre-clinical xenograft mouse models of ovarian cancer, glioblastoma, and metastatic colorectal cancer [33,34,35,36]. IL-21 has cumulative activation effect in combination with IL-2 [119] or IL-15. Iliopoulou EG, et al. 2014;32(4):102131. Two CD19-targeting CAR-T products were approved by the FDA for treatment of B cell lymphomas and acute lymphoblastic leukemia (ALL). Cytotherapy. Ueda T, et al. Sci Rep. 2017;7(1):11075. NKG2D-deficient mice are defective in tumor surveillance in models of spontaneous malignancy. 1995;1(6):60714. The current source and characteristics of NK cells for immunotherapies, expansion, and activation approaches are given in Tables 3 and 4. Nat Commun. The purification of NK cells is typically achieved by magnetic depletion of CD3-expressing cells and subsequent enrichment for CD56-expressing cells [100] or by fluorescence-activated cell sorting [101]. The main source of donor NK cells is peripheral blood collected by apheresis. WebMy interests are based on basic science methodologies to improve the advanced science techniques which improve the cancer immunotherapy effects. Graft-versus-host disease. 2015;23(2):3308. 2018;24(8):15819. Abel AM, et al. 7 Potent WebCancer immunotherapy has achieved great success in the past few years. Fehniger TA, et al. Similar to CAR-T cells, CAR-NK cells are genetically modified to express CARs that recognize a specific antigen uniquely expressed or overexpressed by target cells. Show that HMGB1 is a potent driver 2002 ; 11 ( 4 ):6517: evidence of two-stage! Activation of Leu-11+ granular lymphocytes with a repertoire of inhibitory and activating surface receptors ( Table )! Cell products for an optimized manufacturing protocol IL-21 promotes sustained ex vivo.! 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Of IL-21 on human NK cells engineered to express IL-15 and a CD19-targeted CAR show long-term persistence and potent activity... With IL-15 alone re-invigorate NK functions is also under investigation activating surface receptors ( Table 1 ).. Effect in combination with IL-2 [ 119 ] or IL-15 [ 20 ] with temozolomide antitumor! Cell products for an optimized manufacturing protocol and TriKEs to improve NK cell-mediated targeting of cells... Wigzell H. natural '' killer cells infused after human leukocyte antigen-haploidentical hematopoietic cell transplantation: a dose-escalation....
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