Locoregionally delivered PD-1 blockade augments B7-H3 targeting CAR T cell efficacy in models of glioblastoma.

Glioblastoma (GBM) is a lethal brain tumor with a 95% five-year mortality rate, and remains a major unmet clinical need. An innovative approach to target GBM is administration of chimeric antigen receptor (CAR) T cells. In this study we identified B7-H3 as a favorable target antigen for CAR T cell therapy of GBM and developed a B7-H3 targeting CAR T cell. This CAR demonstrates robust, antigen-specific cytolysis and cytokine production, low tonic signaling, and preservation of a stem/naïve cell phenotype. Using orthotopic xenograft models of GBM we show that a single intravenous administration of this B7-H3 targeted CAR confers tumor control, and long-term survival. We identified upregulation of T cell inhibitory ligands PD-L1 and PD-L2 as a mechanism of resistance, and modified our B7-H3 targeting CAR vector to include a secreted a PD-1 blocking scFv. We further demonstrate that concomitant PD-1 blockade by the secreted PD-1 blocking scFv augments the antitumor capabilities of B7-H3-targeting CAR T cells through increased intratumoral infiltration by the CAR T cells and improved effector function. These data demonstrate B7-H3 targeting CAR T cells with concomitant PD-1 blockade is a safe and efficient method for improving the antitumor capacity of CAR T cells for GBM.