Rajiv Khanna

Rajiv Khanna (QIMR Berghofer Medical Research Institute, Australia)
“Adoptive T Cell Therapy for NPC: Immune Correlates to Immune Contexture”

  • Collaborates with Victor Lee, Dora Kwong, Hohn Nichols, Vivian Li, Daniel Chua, Randall ‘Tis Janice Tsang … at HKU)
  • 2017/10/20 second CD19 CAR-T
  • NPC T cell immunotherapy in the past 10 years
  • Singapore group
  • Adoptive T cell transfer and chemotherapy in the first line treatment of metastatic NPC
  • EBV T cell immunotherapy (emerging developments)
    • ASTRA BIO; Tab-celTM; PTLD
    • TESSA Therapeutics; EBV ST; NPC
  • Manufacturing process for autologous T cell therapies for NPC
    • Step 1 synthetic peptide or viral vector (expressing viral antigen) or EBV-LCL + peripheral blood mononuclear cells+ IL2
    • Step2  T cells +IL2  antigen specific T cells
    • Step 3 Micro Multiepitope technoology: E1-LMPpoly
  • Adenochimera chimera
  • In vitro expansion of EBV-specific T cells from EBV+nasopharyngeal carcinoma patients
    • Other antigens (LMP1, LMP2).
    • ARMD NPC (stage IUV NPC patients (multiple Kline’s of therapy, ; N/MRD: no or minima residual disease)
  • T cell characteristics and response to T n cell therapy
  • Post EBV-specific T cell therapy and progression disease fress and overall survival
  • Immunotherapy: to resond or not to respond, that is the question
  • why some cancers show better clinical response to immunotherapy while other malignancies remain un-responsive
  • Clinical response to immunotherapy
    • 1. Cancer (TME)
    • 2. Immunotherapy-drug produce (potency/delivery)
    • 3. Patient (immunological status)
  • immune contexture of cancer er and repind to immunotherapy
    • multiplex IHC using tyrmide signal amplification
    • Immuno contexture analysis using multiplexed panels
      • Panel 1 CD8, PDL1, TIM-3, T-bel,
      • Multiplexed immunohistochemistry (Reshma Shakya)
      • Intra-tumoral PD-L1 expression and clinical response to checkpoint
  • Future immunological intervention for NPC patients based on PD-L1 expression
    • PD-1 high -> anti-PD1
      • Next a generation “off-the-shelf” EBV T cell therapy manufacturing and distribution
      • Proprietary algorithm (1-2 alleles are enough)
      • 17 studies (281 patients treated 64% CR +10.7% PR)
      • AdE1-LMPpily “off-the-shelf” T cell therapy for NPPC and gastric cancer
      • Ratio of CD8+ top CD4+FoxoP Tim3+
    • Uniquely PD-1 low –> ACT
      • Qualitative profile of EBV-specific T cells impacts on the clinical response of NPC patients

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