# Phase I clinical trial of adoptive transfer of autologous folate receptor-alpha redirected CAR T cells for ovarian cancer

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $626,526

## Abstract

Abstract
Applying CAR T cell therapy to solid tumors such as ovarian cancer (OvCa) is widely considered a major
opportunity but also a major challenge and thus the focus of this proposal. Here, we seek to develop new
clinical strategies for OvCa and other solid tumors using CAR T cells specific for folate receptor-alpha (FRα),
as the target of next generation CAR T cell therapy. FRα is a surface protein that is expressed in 80-90% of
OvCa cases and associated with poor prognosis. FRα is known to be a safe, “druggable” therapeutic target in
trials of antibody drug conjugates and bispecific antibody armed T cells in platinum-resistant OvCa patients,
with clinical response rates of 26% and 27%, respectively. These agents are short-lived in patients and thus
responses are non-enduring; CAR T cells however have the capacity for persistence and maintained activity in
vivo. In multiple preclinical models, human FRα CAR T cells exhibit potent anti-tumor efficacy against human
solid tumor xenografts that express FRα. Here, we propose to test the central hypothesis that lentivirus
engineered FRα-specific CAR T cells can achieve clinically meaningful tumor responses in patients with
recurrent OvCa without untoward toxicity. We propose to (1) determine the feasibility, safety and tumor
response following intraperitoneal injection of autologous FRα lentivirus CAR T cells in patients with confirmed
FRα-overexpressing recurrent OvCa in a phase I dose escalation trial (NCT03585764), (2) determine FRα
CAR persistence, immunological potency and mechanism of FRα-specific CAR T cell activity in treated
patients to understand the immune reaction and other modulations in the OvCa microenvironment following
CAR T cell injection, and (3) determine the scope, breadth, and duration of induced systemic immune
responses, as a foundation for anticipated future combinatorial therapies. In this line, a secondary hypothesis
is that schedule-dependent preconditioning of the tumor microenvironment (TME) is a requirement for effective
therapy. In OvCa and other cancers, tumor associated macrophage (TAM) accumulation is associated with
poor outcome and resistance to immunotherapy, suggesting that TAM depletion or disruption may improve
patient outcome. We have now developed novel CAR T cell technology that mediates deep and highly
selective depletion of immunosuppressive M2-like TAMs. In preclinical studies, we find that anti-TAM CAR T
cells augment endogenous CD8+ T cell antitumor responses, spares M1-like macrophages, re-educates the
TME, and inhibits tumor progression in vivo in three independent mouse tumor models, suggesting that
synergy with FRα CAR T cell therapy may be achieved, particularly when applied as a preparative
preconditioning regimen. We are positioned to test this novel hypothesis by evaluating and optimizing this
novel TAM depletion regimen, and other established approaches, in the context of FRα CAR T cells therapy in
various preclinical tumor models, allowing...

## Key facts

- **NIH application ID:** 10828349
- **Project number:** 5R01CA260902-03
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Daniel J. Powell
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $626,526
- **Award type:** 5
- **Project period:** 2022-04-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10828349

## Citation

> US National Institutes of Health, RePORTER application 10828349, Phase I clinical trial of adoptive transfer of autologous folate receptor-alpha redirected CAR T cells for ovarian cancer (5R01CA260902-03). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10828349. Licensed CC0.

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