title: Gene-modified T cells for adoptive immunotherapy of renal cell cancer maintain transgene-specific immune functions in vivo.
abstract: BACKGROUND
  We have treated three patients with carboxy-anhydrase-IX (CAIX) positive metastatic renal cell cancer (RCC) by adoptive transfer of autologous T-cells that had been gene-transduced to express a single-chain antibody-G250 chimeric receptor [scFv(G250)], and encountered liver toxicity necessitating adaptation of the treatment protocol. Here, we investigate whether or not the in vivo activity of the infused scFv(G250)(+) T cells is reflected by changes of selected immune parameters measured in peripheral blood.
  
  
  METHODS
  ScFv(G250)-chimeric receptor-mediated functions of peripheral blood mononuclear cells (PBMC) obtained from three patients during and after treatment were compared to the same functions of scFv(G250)(+) T lymphocytes prior to infusion, and were correlated with plasma cytokine levels.
  
  
  RESULTS
  Prior to infusion, scFv(G250)(+) T lymphocytes showed in vitro high levels of scFv(G250)-chimeric receptor-mediated functions such as killing of CAIX(+) RCC cell lines and cytokine production upon exposure to these cells. High levels of IFN-gamma were produced, whilst production of TNF-alpha, interleukin-4 (IL-4), IL-5 and IL-10 was variable and to lower levels, and that of IL-2 virtually absent. PBMC taken from patients during therapy showed lower levels of in vitro scFv(G250)-receptor-mediated functions as compared to pre-infusion, whilst IFN-gamma was the only detectable cytokine upon in vitro PBMC exposure to CAIX. During treatment, plasma levels of IFN-gamma increased only in the patient with the most prominent liver toxicity. IL-5 plasma levels increased transiently during treatment in all patients, which may have been triggered by the co-administration of IL-2.
  
  
  CONCLUSIONS
  ScFv(G250)-receptor-mediated functions of the scFv(G250)(+) T lymphocytes are, by and large, preserved in vivo upon administration, and may be reflected by fluctuations in plasma IFN-gamma levels.
authors.affiliation: Laboratory for Clinical and Tumor Immunology, Department of Medical Oncology, Erasmus MC, Daniel den Hoed Cancer Center, PO Box 5201, 3008 AE, Rotterdam, The Netherlands. c.lamers@erasmusmc.nl
authors.forename: Cor H J
authors.initials: CH
authors.lastname: Lamers
authors.forename: Sabine C L
authors.initials: SC
authors.lastname: Langeveld
authors.forename: Corrien M
authors.initials: CM
authors.lastname: Groot-van Ruijven
authors.forename: Reno
authors.initials: R
authors.lastname: Debets
authors.forename: Stefan
authors.initials: S
authors.lastname: Sleijfer
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Gratama
mesh_terms: D002292:Carcinoma, Renal Cell / Q000378:metabolism*; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D007107:Immune System; D007167:Immunotherapy / Q000379:methods; D016219:Immunotherapy, Adoptive / Q000379:methods*; D007371:Interferon-gamma / Q000378:metabolism; D007680:Kidney Neoplasms / Q000378:metabolism*; D007700:Kinetics; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D012190:Retroviridae / Q000378:metabolism; D013601:T-Lymphocytes / Q000166:cytology* / Q000378:metabolism; D019076:Transgenes; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma