GM-CSF Knock-out CAR-T Study Published in Peer-Reviewed Journal Leukemia
Humanigen, Inc. (Nasdaq: HGEN) announced a significant advancement in CAR-T therapies through a peer-reviewed publication in Leukemia. The study highlights the effectiveness of CRISPR/Cas9-mediated GM-CSF knock-out CAR-T cells, which exhibit reduced apoptosis and improved anti-tumor activity in vivo. With the upcoming Phase 3 SHIELD study aimed at assessing lenzilumab's role in preventing common toxicities associated with CAR-T therapies, this research underscores the potential to enhance treatment efficacy while minimizing adverse effects. Lenzilumab, a first-in-class monoclonal antibody, is critical in managing cytokine storms.
- Publication in Leukemia highlights GM-CSF knockout CAR-T cell advancement.
- Phase 3 SHIELD study to investigate lenzilumab's efficacy in mitigating CAR-T toxicities.
- Preclinical results indicating enhanced anti-tumor activity with GM-CSF knockout CAR-T cells.
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- CRISPR/Cas9-Mediated GM-CSF knock-out (GM-CSFko) CAR-T cells demonstrate reduced apoptosis and enhanced in vivo anti-tumor activity in preclinical models
- Phase 3 SHIELD study utilizing lenzilumab to prophylactically neutralize GM-CSF in CAR-T to begin 1H22
This publication is a significant addition to the findings from a previous article in the leading hematology journal, blood, which demonstrated that neutralization of GM-CSF with lenzilumab (LENZ®) was able to break the efficacy/toxicity linkage by reducing cytokine release syndrome (CRS) and neuroinflammation (ICANS) while enhancing CAR-T function.1 The Leukemia publication demonstrates that CRISPR/Cas9-mediated GM-CSF knockout in CAR-T cells directly ameliorates CAR-T cell early activation, reduces activation-induced cell death, and results in enhanced anti-tumor activity in vivo in a xenograft model.2
Enhancing CAR-T cell in vivo efficacy by using strategies to non-specifically stimulate CAR-T cell proliferation utilizing synthetic biology or combination therapy to edit exhaustion pathways or prevent apoptosis is an important goal and is the subject of substantial ongoing research. However, while this may improve CAR-T efficacy, it is often at the cost of an increase in important toxicities, such as CRS and ICANS. In contrast, these data published in Leukemia indicate that GM-CSFko CAR-T cells result in enhanced CAR-T cell proliferation and anti-tumor activity while being associated with a marked reduction in GM-CSF levels, which have been linked to CAR-T associated toxicities.
CAR-T therapies have resulted in significant advances for patients. However, for up to one-third of patients, toxicities such as severe ICANS and CRS occur, and tumor relapse is still a frequent occurrence.3 Currently, the widespread adoption of CAR-T therapy is limited, in part, by the requirement for treatment in centers that are experienced in managing the common toxicities of ICANS and CRS and by the financial and health burden that this creates. “CRS, ICANS, and tumor relapse remain challenges for physicians and patients treated with CAR-T therapy,” said
This publication adds to the body of knowledge of GM-CSF depletion in CAR-T. The upcoming Phase 3 CAR-T study, known as SHIELD, will determine the efficacy and safety of prophylactic lenzilumab on the rates of ICANS, CRS, and CAR-T efficacy. “The SHIELD trial has been designed to build on the positive results from the ZUMA-19 study. The primary endpoint of SHIELD will focus on demonstrating a significant improvement in neurotoxicity associated with both Yescarta® and Tecartus®. We will also seek to explore the beneficial impact that lenzilumab may have CAR-T efficacy,” stated
About Lenzilumab
Lenzilumab is a proprietary Humaneered® first-in-class monoclonal antibody that has been proven to neutralize GM-CSF, a cytokine of critical importance in the hyperinflammatory cascade, sometimes referred to as cytokine release syndrome, or cytokine storm, associated with COVID-19 and other indications. Lenzilumab binds to and neutralizes GM-CSF, potentially improving outcomes for patients hospitalized with COVID-19.
In CAR-T, lenzilumab successfully achieved the pre-specified primary endpoint at the recommended dose in a Phase 1b study (ZUMA-19) with Yescarta® in which the overall response rate was
A study of lenzilumab is also underway for patients with chronic myelomonocytic leukemia (CMML) exhibiting RAS pathway mutations. This study builds on evidence from a Phase 1 study, conducted by
Lenzilumab is an investigational product and is not approved or authorized in any country.
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All statements other than statements of historical facts contained in this press release are forward-looking statements. Forward-looking statements reflect management's current knowledge, assumptions, judgment, and expectations regarding future performance or events. Although management believes that the expectations reflected in such statements are reasonable, they give no assurance that such expectations will prove to be correct, and you should be aware that actual events or results may differ materially from those contained in the forward-looking statements. Words such as "will," "expect," "intend," "plan," "potential," "possible," "goals," "accelerate," "continue," and similar expressions identify forward-looking statements, including, without limitation, statements regarding the SHIELD and LIVE-AIR studies, and other statements regarding improving the safety and efficacy of CAR-T and our plans relating to lenzilumab and ifabotuzumab.
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References
- Sterner, R. et al. (2019). GM-CSF inhibition reduces cytokine release syndrome and neuroinflammation but enhances CAR-T cell function in xenografts. blood. https://doi.org/10.1182/blood-2018-10-881722
- Cox, M. et al. (2022). GM-CSF disruption in CART cells modulates T cell activation and enhances CART cell anti-tumor activity. Leukemia. https://doi.org/10.1038/s41375-022-01572-7
- Morris, E. et al. (2021). Cytokine release syndrome and associated neurotoxicity in cancer immunotherapy. Nature Reviews Immunology. https://doi.org/10.1038/s41577-021-00547-6
LENZ® is a trademark of
Yescarta® and Tecartus® are trademarks of Gilead Sciences, Inc., or its related companies.
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