Oral Presentation ESA-SRB 2023 in conjunction with ENSA

Unlocking the potential of CAR T cell immunotherapy for the treatment of prostate cancer (#18)

Laura H Porter 1 , Joe J Zhu 2 , Natalie L Lister 1 , Sophie G Harrison 1 , Shiva Keerthikumar 2 , David L Goode 2 , Rosalia Quezada Urban 2 , David J Byrne 2 , Arun Azad 2 , Ian Vela 3 , Michael S Hofman 2 , Paul J Neeson 2 , Phillip K Darcy 2 , Joseph A Trapani 2 , Renea A Taylor 1 , Gail P Risbridger 1
  1. Monash University, Clayton, VIC, Australia
  2. Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  3. Queensland University of Technology, Brisbane, Queensland, Australia

Despite significant improvements in detection and treatment, advanced prostate cancer remains incurable. When androgen receptor (AR)-targeted therapies fail, it is challenging to find new treatments to eradicate resistant tumours. Immunotherapy with genetically engineered chimeric-antigen receptor (CAR) T cells is a profound advance in cancer therapy. However, the suppressive tumour microenvironment (TME) is a significant barrier to CAR T cell efficacy in solid tumours, including prostate cancer. Here, we assessed the effectiveness of Lewis Y (LeY) CAR T cell therapy using patient-derived xenografts (PDXs) of prostate cancer from the Monash Urology Research Alliance (MURAL). As LeY is not a predicted target antigen for prostate cancer treatment, we first assessed the expression of LeY on 800 prostate cancer patient specimens plus 49 patient-derived xenografts (PDXs). LeY was expressed on 12% of localized and 20% of metastatic tumours, and in 57% of PDXs. In vitro, LeY CAR T cells directly killed organoids derived from AR-positive or AR-null PDXs. In vivo, LeY CAR T cells alone did not affect tumour growth, but a single prior dose of carboplatin resulted in tumour eradication. Carboplatin induced a pro-inflammatory TME that facilitated early and durable CAR T cell infiltration, including an altered cancer-associated fibroblast phenotype, enhanced extracellular matrix degradation and M1 macrophage differentiation. In a PDX less sensitive to carboplatin treatment, carboplatin did not boost CAR T cell infiltration; however, a reduction in tumour burden was still observed with increased T cell activation. Therefore, carboplatin improves the efficacy of CAR T cell treatment, with the extent of the response dependent on changes induced within the TME. As LeY expression was independent of AR expression, and both AR-positive and AR-null tumours were sensitive to LeY CAR T cells in vitro, LeY CAR T cells may provide a treatment option for patients who would not benefit from AR-directed therapies.

  1. Porter, L.H., Zhu, J.J., Lister, N.L., Harrison, S.G., Keerthikumar, S., Goode, D.L., Quezada Urban, R., Byrne, D.J., Azad, A., Vela, I., Hofman, M.S., Neeson, P.J., Darcy, P.K., Trapani, J.A., Taylor, R.A. & Risbridger, G.P. Low-dose carboplatin modifies the tumor microenvironment to augment CAR T cell effcacy in human prostate cancer models. Nature Communications In Press(2023)