Intrathecal CRISPR-edited allogeneic IL-13Rα2 CAR T Cells for recurrent high-grade Glioma: preclinical characterization and phase I trial

Nat Commun. 2026 Jan 6;17(1):1362. doi: 10.1038/s41467-025-68112-6.

Abstract

Patients with recurrent high-grade glioblastoma have a median survival of 6-8 months, with limited therapeutic options. In recent years, interest has grown in applying chimeric antigen receptor T (CAR-T) cells to solid cancers, including advanced gliomas. Here we generated off-the-shelf CRISPR-Cas9-edited IL-13Rα2-specific allogeneic universal CAR-T cells (MT026) by disrupting the endogenous TCR to prevent graft-versus-host disease and knocking out HLA class I molecules to mitigate the host-versus-graft response, and observed minimal NK-cell-mediated rejection in preclinical studies. In a first-in-human, single-center, open-label investigator-initiated trial (ChiCTR2000028801) in patients with high-grade glioma with prior therapy failure and short life expectancy, intrathecal injection of MT026 via lumbar puncture (1.0-3.0×10^7 cells per dose) demonstrated favorable tolerability and safety (primary outcome), pharmacokinetic characteristics, and preliminary clinical activity (secondary outcomes). Among the five patients enrolled, one achieved a complete response and three achieved partial responses. No grade ≥3 adverse events were observed; the predominant treatment-related toxicities were grade 1-2 pyrexia, hypoxia, and vomiting. Trial enrolment was halted after enrolment of the first five patients, however these preliminary clinical data support the potential benefit of locally administered allogeneic universal CAR-T cell therapy for recurrent glioblastoma.

Publication types

  • Clinical Trial, Phase I

MeSH terms

  • Adult
  • Aged
  • Animals
  • Brain Neoplasms* / immunology
  • Brain Neoplasms* / pathology
  • Brain Neoplasms* / therapy
  • CRISPR-Cas Systems / genetics
  • Cell Line, Tumor
  • Female
  • Gene Editing
  • Glioblastoma / immunology
  • Glioblastoma / therapy
  • Glioma* / immunology
  • Glioma* / pathology
  • Glioma* / therapy
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / prevention & control
  • Humans
  • Immunotherapy, Adoptive* / adverse effects
  • Immunotherapy, Adoptive* / methods
  • Interleukin-13 Receptor alpha2 Subunit* / genetics
  • Interleukin-13 Receptor alpha2 Subunit* / immunology
  • Killer Cells, Natural / immunology
  • Male
  • Mice
  • Middle Aged
  • Neoplasm Recurrence, Local / therapy
  • Receptors, Chimeric Antigen* / genetics
  • Receptors, Chimeric Antigen* / immunology
  • T-Lymphocytes* / immunology
  • T-Lymphocytes* / metabolism
  • T-Lymphocytes* / transplantation
  • Treatment Outcome

Substances

  • Interleukin-13 Receptor alpha2 Subunit
  • Receptors, Chimeric Antigen