Chimeric-antigen-receptor-T (CAR-T) cells are currently revolutionizing the field of cancer immunotherapy. Therefore, there is an urgent need for CAR-T cell monitoring by clinicians to assess cell expansion and persistence in patients. CAR-T cell manufacturers and researchers need to evaluate transduction efficiency and vector copy number for quality control. Here, CAR expression was analyzed in peripheral blood samples from patients and healthy donors by flow cytometry with four commercially available detection reagents and on the gene level by quantitative polymerase chain reaction (qPCR). Flow cytometric analysis of CAR expression showed higher mean CAR expression values for CD19 CAR detection reagent and the F(ab’)2 antibody than Protein L and CD19 Protein. In addition, the CD19 CAR detection reagent showed a significantly lower median background staining of 0.02% (range 0.007–0.06%) when compared to the F(ab’)2 antibody, CD19 protein and Protein L with 0.80% (range 0.47–1.58%), 0.65% (range 0.25–1.35%) and 0.73% (range 0.44–1.23%). Furthermore, flow cytometry-based CAR-T cell frequencies by CD19 CAR detection reagent showed a good correlation with qPCR results. In conclusion, quality control of CAR-T cell products can be performed by FACS and qPCR. For the monitoring of CAR-T cell frequencies by FACS in patients, CAR detection reagents with a low background staining are preferable.
Introduction: After approval of CD19.CAR-T cell therapy by both FDA and EMA, chimeric antigen receptor T (CAR-T) cell therapy has been established as a new and innovative therapy method for patients with relapsed/refractory acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL). Because of this, there is great need for reliable methods for CAR-T cell monitoring by clinicians to further assess cell expansion, distribution and persistence in patients. This is both necessary for CAR-T cell manufacturing sites and researchers to assess transduction efficiency and vector copy numbers per cell. Therefore, we analyzed CAR expression of CD19.CAR-T cells using flow cytometry as well as quantitative polymerase chain reaction (qPCR). Methods: In this study, four different commercially available CD19.CAR-T cell staining reagents (Protein L, CD19 protein, F(ab`)2 antibody, and CD19.CAR-T cell detection reagent) were used to evaluate CAR-T cell products and peripheral blood samples of both patients and healthy donors by flow cytometry. Furthermore, qPCR was performed with data comparison using flow cytometry results. Results: Flow cytometric analysis of CAR expression showed higher mean CAR expression values for CD19 CAR detection reagent and the F(ab')2 antibody than Protein L and CD19 Protein. Moreove, the CD19 CAR detection reagent showed a significantly lower median background staining of 0.02% (range 0.007-0.06%) when compared to F(ab')2 antibody, CD19 protein and Protein L with 0.80% (range 0.47-1.58%.), 0.68% (range 0.30-1.38%) and 0.73% (range 0.44-1.23%). Furthermore, flow cytometry-based CAR-T cell frequencies by CD19 CAR detection reagent showed a good correlation with qPCR results. Conclusion: CAR-T staining was successfully performed with all tested commercially available CAR detection reagents. Evaluation of manufactured CAR-T cells as well as quality control was comparably done using FACS and qPCR. Because of lower frequencies of CAR-T cells in the patient samples, CAR-T cell staining reagents with a low background staining should be preferably used. Disclosures Sauer: Abbvie: Consultancy, Speakers Bureau; Pfizer: Consultancy, Speakers Bureau; Matterhorn Biosciences AG: Consultancy, Other: DSMB/SAB Member; Takeda: Consultancy, Other: DSMB/SAB Member. Schubert: Gilead: Consultancy. Müller-Tidow: Janssen: Consultancy, Research Funding; Bioline: Research Funding; Pfizer: Research Funding. Schmitt: TolerogenixX: Current holder of individual stocks in a privately-held company; Novartis: Other: Travel grants, Research Funding; MSD: Membership on an entity's Board of Directors or advisory committees; Kite Gilead: Other: Travel grants; Apogenix: Research Funding; Hexal: Other: Travel grants, Research Funding; Bluebird Bio: Other: Travel grants. Schmitt: Hexal: Other: Travel grant; Therakos/Mallinckrodt: Research Funding; Jazz Pharmaceuticals: Other: Travel grant; TolerogenixX Ltd: Current Employment.
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