# Third-party “off the shelf” mature or precursor CAR T cells to prevent or treat malignant relapse after allo HCT

> **NIH NIH R01** · SLOAN-KETTERING INST CAN RESEARCH · 2021 · $663,330

## Abstract

Abstract
Relapse remains the most important cause of mortality after allogeneic hematopoietic cell
transplantation (allo-HCT) and little progress has been made in the past decades. Chimeric
antigen receptors targeting CD19 (CD19-CARs) redirect T cell effector functions to eliminate
CD19-expressing leukemia and lymphoma cells. We found in pre-clinical studies that allogeneic
donor-derived CD19-CAR T cells can have significant anti-lymphoma activity with minimal graft-
versus-host disease (GVHD), an observation that was confirmed by others in clinical trials. We
found that this was due to exhaustion and deletion of CAR-T cells attributable to cumulative
signaling through both the alloreactive TCR and the CAR. In addition, we have demonstrated the
feasibility of deletion of the endogenous TCR and expression of a CD19-CAR in T cells using
CRISPR technology, which could further reduce potential alloreactivity of these cells. We have
also developed an in vitro culture system to generate universal third-party T cell precursors (preT)
that can be engineered to express CD19-CAR post-thymically to avoid negative selection. Upon
adoptive transfer in allo-HCT recipients, these engineered preT cells can mature in the host’s
thymus and exert anti-malignancy activity without GVHD. In addition to anti-malignancy potential,
these engineered preT cells can also enhance immune reconstitution. Based on these findings
and the clinical efficacy of adoptively transferred third party anti-viral T cells in allo-HCT recipients,
we hypothesize that infusion of third-party “off-the-shelf” mature or preT cells expressing CARs
and TCRs targeted against tumor-associated antigens will promote anti-malignancy activity and
enhance immune reconstitution in allo-HCT recipients with minimal or no GVHD. We propose pre-
clinical studies with engineered third-party mature and preT cells to prevent or treat relapse after
allo-HCT. In Aim 1, we will use pre-clinical allo-HCT models to evaluate the anti-malignancy
activity, GVHD potential and persistence of third-party T cells whose endogenous TCR has been
deleted using CRISPR and that express (1.1) CD19-CAR, (1.2) triple-antigen-specific CARs, or
(1.3) CD19-CAR/WT-1 specific TCR. In Aim 2, we will study third-party preT cells expressing (2.1)
a CD19-CAR, (2.2) a CD19-CAR and cytokines, or (2.3) CD19-CAR/WT1 specific TCR. We have
already developed two allo-HCT clinical trials with donor-derived CD19-CAR T cells or third-party
preT cells, which together with our extensive clinical experience with CAR T cells will facilitate the
translation of the proposed preclinical studies to decrease relapse in allo-HCT patients with
hematologic malignancies using third party CAR T cells.

## Key facts

- **NIH application ID:** 10179457
- **Project number:** 5R01HL147584-03
- **Recipient organization:** SLOAN-KETTERING INST CAN RESEARCH
- **Principal Investigator:** Marcel R M van den Brink
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $663,330
- **Award type:** 5
- **Project period:** 2019-08-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10179457

## Citation

> US National Institutes of Health, RePORTER application 10179457, Third-party “off the shelf” mature or precursor CAR T cells to prevent or treat malignant relapse after allo HCT (5R01HL147584-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10179457. Licensed CC0.

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