# Leveraging small molecule inhibitors to improve CD19 CAR T cell immunotherapy for KMT2A-rearranged ALL

> **NIH NIH K08** · CHILDREN'S HOSP OF PHILADELPHIA · 2024 · $23,920

## Abstract

PROJECT SUMMARY/ABSTRACT
This K08 mentored career development award proposal details a research and training plan that is designed to
facilitate the career development and transition of Lisa Niswander, MD PhD to an independent physician-scientist
investigator. Dr. Niswander is a pediatric oncologist and an Instructor of Pediatrics at the Children’s Hospital of
Philadelphia (CHOP) and University of Pennsylvania (Penn). Her long-term goal is to lead an NIH-funded
research program focused on the preclinical development and early bench-to-bedside translation of targeted
therapies and immunotherapies to improve outcomes for children with leukemia. During the 5-year award period,
critical technical and scientific training will be acquired in T cell and chimeric antigen receptor (CAR) T cell
immunobiology, single cell transcriptomics, early-phase clinical trial design, leadership, and scientific
communication. Under the primary mentorship of Dr. Sarah Tasian, a leader in the development of molecularly-
targeted and CAR T cell therapies for high-risk pediatric leukemias, and co-mentorship of Dr. Martin Carroll, an
expert in acute leukemia signaling, in tandem with a complementary advisory committee of senior scientists, this
scientific research program and training plan will be bolstered by the resource-rich environment at CHOP/Penn.
Despite high cure rates in most children with B-cell acute lymphoblastic leukemia (B-ALL), infants with B-ALL
have dismal outcomes. Most cases of infant B-ALL are characterized by KMT2A rearrangements (KMT2A-R)
with resulting fusion proteins that complex with critical adaptor protein menin to drive leukemogenesis and/or by
frequent activating RAS pathway mutations. Promising preclinical and early clinical efforts have focused on small
molecule disruption of KMT2A-menin binding (menin-i) and on MEK inhibitor (MEK-i) blockade of RAS signaling.
CD19-directed CAR T cell immunotherapy (CD19CART) has achieved high response rates in children with B-
ALL, including infants with KMT2A-R ALL. However, at least 50% of these patients will ultimately relapse. The
central hypothesis of this proposal is that combining CD19CART with pharmacologic disruption of specific
KMT2A-R ALL biologic vulnerabilities, including menin-binding or aberrant RAS signaling, will improve treatment
efficacy and long-term remission in KMT2A-R ALL. To test this hypothesis, the combinatorial strategy of menin-
i (Aim 1) and MEK-i (Aim 2) with CD19CART against KMT2A-R ALL will be investigated. The effects of these
dual approaches will be elucidated for both anti-leukemia therapeutic activity and for CD19CART functionality
and persistence. Successful completion of this career development award will identify promising co-therapeutic
strategies with CD19CART poised for rapid clinical translation for children with KMT2A-R ALL. These research
and training efforts will also propel Dr. Niswander’s transition to independence by establishing a robust scientific
pipeline fo...

## Key facts

- **NIH application ID:** 10983578
- **Project number:** 1K08CA286765-01A1
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Lisa Madalen Niswander
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $23,920
- **Award type:** 1
- **Project period:** 2024-07-17 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10983578

## Citation

> US National Institutes of Health, RePORTER application 10983578, Leveraging small molecule inhibitors to improve CD19 CAR T cell immunotherapy for KMT2A-rearranged ALL (1K08CA286765-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10983578. Licensed CC0.

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