Authorship Contribution:
Conception and design: Y-T Tai, K C Anderson
Development of methodology: L Lin, S-F Cho, L Xing, Y Li
Acquisition of data (provided reagents, facilities, etc.): L Lin, S-F Cho, L Xing, T Yu, Y Li, K Wen, P A Hsieh
Reagents and Materials: M Kurtoglu, Y Zhang, C A Stewart
Animal work and in vivo data analysis: Y-T, Tai, M Kurtoglu, Y Zhang, C A Stewart
Analysis and interpretation of data (statistical analysis, biostatistics analysis): L Lin, S-F Cho, L Xing, T Yu, Y Li, K Wen, P A Hsieh, H, Chen
Provided and managed patients: N Munshi, KC Anderson
Writing, review, and/or revision of the manuscript: K C Anderson, Y-T Tai
Study supervision: K C Anderson, Y-T Tai
All authors critically reviewed and approved this paper.
Chimeric antigen receptor (CAR) T-cell therapy remains limited to select centers that can carefully monitor adverse events. To broaden use of CAR T-cells in community clinics and in a frontline setting, we developed a novel CD8+ CAR T-cell product, Descartes-08, with predictable pharmacokinetics for treatment of multiple myeloma. Descartes-08 is engineered by mRNA transfection to express anti-BCMA CAR for a defined length of time. Descartes-08 express anti-BCMA CAR for 1 week, limiting risk of uncontrolled proliferation; produce inflammatory cytokines in response to myeloma target cells; and are highly cytolytic against myeloma cells regardless of presence of myeloma-protecting bone marrow stromal cells, exogenous a proliferation-inducing ligand, or drug resistance including IMiDs. The magnitude of cytolysis correlates with anti-BCMA CAR expression duration, indicating a temporal limit in activity. In the mouse model of aggressive disseminated human myeloma, Descartes-08 induces BCMA CAR-specific myeloma growth inhibition and significantly prolongs host survival (P<.0001). These preclinical data, coupled with an ongoing clinical trial of Descartes-08 in relapsed/refractory myeloma (NCT03448978) showing preliminary durable responses and a favorable therapeutic index, have provided the framework for a recently initiated trial of an optimized/humanized version of Descartes-08 (i.e., Descartes-11) in newly diagnosed myeloma patients with residual disease after induction therapy.