Tumor-Specific T-Cells Engineered to Overcome Tumor Immune Evasion Induce Clinical Responses in Patients With Relapsed Hodgkin Lymphoma

J Clin Oncol. 2018 Apr 10;36(11):1128-1139. doi: 10.1200/JCO.2017.74.3179. Epub 2018 Jan 9.


Purpose Transforming growth factor-β (TGF-β) production in the tumor microenvironment is a potent and ubiquitous tumor immune evasion mechanism that inhibits the expansion and function of tumor-directed responses; therefore, we conducted a clinical study to discover the effects of the forced expression of a dominant-negative TGF-β receptor type 2 (DNRII) on the safety, survival, and activity of infused tumor-directed T cells. Materials and Methods In a dose escalation study, eight patients with Epstein Barr virus-positive Hodgkin lymphoma received two to 12 doses of between 2 × 107 and 1.5 × 108 cells/m2 of DNRII-expressing T cells with specificity for the Epstein Barr virus-derived tumor antigens, latent membrane protein (LMP)-1 and LMP-2 (DNRII-LSTs). Lymphodepleting chemotherapy was not used before infusion. Results DNRII-LSTs were resistant to otherwise inhibitory concentrations of TGF-β in vitro and retained their tumor antigen-specific activity. After infusion, the signal from transgenic T cells in peripheral blood increased up to 100-fold as measured by quantitative polymerase chain reaction for the transgene, with a corresponding increase in the frequency of functional LMP-specific T cells. Expansion was not associated with any acute or long-term toxicity. DNRII-LSTs persisted for up to ≥ 4 years. Four of the seven evaluable patients with active disease achieved clinical responses that were complete and ongoing in two patients at > 4 years, including in one patient who achieved only a partial response to unmodified tumor-directed T cells. Conclusion TGF-β-resistant tumor-specific T cells safely expand and persist in patients with Hodgkin lymphoma without lymphodepleting chemotherapy before infusion. DNRII-LSTs can induce complete responses even in patients with resistant disease. Expression of DNRII may be useful for the many other tumors that exploit this potent immune evasion mechanism.

Trial registration: ClinicalTrials.gov NCT00368082.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cell Proliferation
  • Cells, Cultured
  • Female
  • Genetic Therapy / adverse effects
  • Genetic Therapy / methods*
  • Herpesvirus 4, Human / immunology
  • Herpesvirus 4, Human / metabolism
  • Hodgkin Disease / immunology
  • Hodgkin Disease / metabolism
  • Hodgkin Disease / therapy*
  • Hodgkin Disease / virology
  • Humans
  • Immunotherapy, Adoptive / adverse effects
  • Immunotherapy, Adoptive / instrumentation*
  • Lymphocyte Activation
  • Male
  • Middle Aged
  • Phenotype
  • Receptor, Transforming Growth Factor-beta Type II / genetics*
  • Receptor, Transforming Growth Factor-beta Type II / immunology
  • Receptor, Transforming Growth Factor-beta Type II / metabolism
  • Recurrence
  • T-Lymphocytes / immunology
  • T-Lymphocytes / metabolism
  • T-Lymphocytes / transplantation*
  • Time Factors
  • Treatment Outcome
  • Tumor Escape*
  • Tumor Microenvironment
  • Viral Matrix Proteins / immunology
  • Viral Matrix Proteins / metabolism


  • EBV-associated membrane antigen, Epstein-Barr virus
  • Viral Matrix Proteins
  • Receptor, Transforming Growth Factor-beta Type II
  • TGFBR2 protein, human

Associated data

  • ClinicalTrials.gov/NCT00368082