Despite the improvement, approximately 60% of patients with relapsed or refractory (r/r) aggressive B cell lymphoma (B-NHL) do not achieve durable benefit from CAR-T cell therapy. To elucidate factors associated with CAR-T therapy resistance, we conducted high-dimensional analyses of pre- and post-CAR-T cell specimens. In patients with non-durable response, we identified a prognostically relevant lymphoma-associated myeloid-monocytic (LAMM) gene signature. In-depth profiling revealed a distinct CSF1R+CD14+CD68+ LAMM cell population in both human and murine B-NHL that inhibits CAR-T cell function and correlates with poor outcome. Cell-cell inference analysis uncovered that LAMM cells impair CAR-T cell function through a direct LAMM-T cell interaction via the PGE2-EP2/EP4 axis. In an autochthonous lymphoma mouse model, combined anti-CD19 CAR-T cell therapy with CSF1R blockade exhibited synergistic effects and improved survival. These findings provide strong rationale for combining anti-CD19 CAR-T cells with CSF1R inhibitors in treating r/r aggressive B-NHL patients.
Institut(e)Unit for Clinical Pharmacology (KKG-EKLiP)
FörderungenDeutsche Krebshilfe (German Cancer Aid) Else Kroner-Fresenius Foundation (EKFS) Ministry of Culture and Science of the State of Northrhine Westphalia (Germany) as part of the Cancer Center Cologne Essen CANTAR network through the program "Netzwerke 2021" Koln Fortune grant Deutsche Forschungsgemeinschaft (German Research Foundation) Faculty of Medicine Cologne ERA-PerMed program (HighRisk-HighGain consortium) Bavarian Cancer Research Center (BZKF, TANGO) Dr.-Rurainski Foundation Fritz Bender Foundation Deutsche Jose Carreras Leukamie-Stiftung Hector Foundation Bavarian Research Foundation (BAYCELLATOR) Bruno and Helene Joster Foundation Monika Kutzner Foundation for Cancer Research German Center for Infection Research (DZIF, TTU-TB grants) German Federal Ministry of Education and Research (BMBF) European Research Council Marie Sklodowska-Curie Training Network for Optimizing Adoptive T Cell Therapy of Cancer (Horizon 2020 programme of the European Union) European Union Innovative Medicines Initiative 2 Joint Undertaking program CMMC Wilhelm Sander-Stiftung Go-Bio-Initiative Imhoff Stiftung Bavarian Ministry for Economical Affairs Koln Fortune Program Bundesministerium fur Bildung und Forschung Jubilaumsstiftung 1988 (University of Cologne)