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Gastroenterology. 2019 Jan 31. pii: S0016-5085(19)30348-8. doi: 10.1053/j.gastro.2019.01.251. [Epub ahead of print]
Use of Expression Profiles of HBV DNA Integrated Into Genomes of Hepatocellular Carcinoma Cells to Select T Cells for Immunotherapy.
Tan AT1, Yang N2, Krishnamoorthy TL3, Oei V1, Chua A4, Xinyuan Z4, Si TH4, Chia A1, Le Bert N1, Low D5, Tan HK3, Kumar R3, Irani FG6, Zong HZ4, Zhang Q7, Guccione E5, Lu-En W8, Koh S8, Hwang W9, Chow WC3, Bertoletti A10.
Author information
1
Emerging Infectious Diseases, Duke-NUS Medical School, Singapore.
2
Genome Institute of Singapore, Agency for Science and Technology (A*STAR), Singapore.
3
Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore.
4
Lion TCR Pte Ltd, Singapore.
5
Institute of Molecular and Cell Biology, Agency for Science and Technology (A*STAR), Singapore.
6
Department of Vascular & Interventional Radiology, Singapore General Hospital, Singapore.
7
Department of Biotherapy, The Third Affiliated Hospital of Sun Yat-Sen University, Guandong, China.
8
Lion TCR Pte Ltd, Singapore; Singapore Immunology Network, Agency for Science and Technology (A*STAR), Singapore.
9
Department of Haematology, Singapore General Hospital, Singapore.
10
Emerging Infectious Diseases, Duke-NUS Medical School, Singapore; Singapore Immunology Network, Agency for Science and Technology (A*STAR), Singapore. Electronic address: [email protected].
Abstract
BACKGROUND & AIMS:
Hepatocellular carcinoma (HCC) is often associated with hepatitis B virus (HBV) infection. Cells of most HBV-related HCCs contain HBV DNA fragments that do not encode entire HBV antigens. We investigated whether these integrated HBV DNA fragments encode epitopes that are recognized by T cells and whether their presence in HCCs can be used to select HBV-specific T-cell receptors (TCRs) for immunotherapy.
METHODS:
HCC cells negative for HBV antigens, based on immunohistochemistry, were analyzed for the presence of HBV mRNAs by real-time PCR, sequencing, and Nanostring approaches. We tested the ability of HBV mRNA-positive HCC cells to generate epitopes that are recognized by T cells using HBV-specific T cells and TCR-like antibodies. We then analyzed HBV gene expression profiles of primary HCCs and metastases from 2 patients with HCC recurrence after liver transplantation. Using the HBV transcript profiles, we selected, from a library of TCRs previously characterized from patients with self-limited HBV infection, the TCR specific for the HBV epitope encoded by the detected HBV mRNA. Autologous T cells were engineered to express the selected TCRs, through electroporation of mRNA into cells, and these TCR T cells were adoptively transferred to the patients in increasing numbers (1x104-10x106 TCR+ T cells/kg) weekly for 112 days or 1 year. We monitored patients' liver function, serum levels of cytokines, and standard blood parameters. Anti-tumor efficacy was assessed based on serum levels of alpha fetoprotein and computed tomography of metastases.
RESULTS:
HCC cells that did not express whole HBV antigens contained short HBV mRNAs, which encode epitopes that are recognized by and activate HBV-specific T cells. Autologous T cells engineered to express TCRs specific for epitopes expressed from HBV DNA in patients' metastases were given to 2 patients without notable adverse events. The cells did not affect liver function over a 1-year period. In 1 patient, 5 of 6 pulmonary metastases decreased in volume during the 1-year period of T-cell administration.
CONCLUSIONS:
HCC cells contain short segments of integrated HBV DNA that encodes epitopes that are recognized by and activate T cells. HBV transcriptomes of these cells could be used to engineer T cells for personalized immunotherapy. This approach might be used to treat a wider population of patients with HBV-associated HCC.
Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
Adoptive T-cell transfer; HCC; TCR; TCR T-cell
PMID:
30711630
DOI:
10.1053/j.gastro.2019.01.251
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