Evidence map›Paper›PMID 39095503›Full record

ArticleLeukemia2024

Rational combinatorial targeting by adapter CAR-T-cells (AdCAR-T) prevents antigen escape in acute myeloid leukemia.

Daniel Atar, Lara Ruoff, Anna-Sophia Mast, Simon Krost, Moustafa Moustafa-Oglou, Sophia Scheuermann, Beate Kristmann, Maximilian Feige, Aysegül Canak, Kathrin Wolsing and 15 more

Abstract read
In one paragraph

Article in Leukemia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Recent advances in CAR T and CAR NK cell therapy for AML.International journal of hematology · 2026
    Review
  5. Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Review
  16. Review
  17. The Current Landscape of Modular CAR T Cells.International journal of molecular sciences · 2025
    Review
  18. Review
  19. Review
  20. Strategic innovations: Tackling challenges of immunotherapy in acute myeloid leukemia.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Daniel AtarDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Lara RuoffDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Anna-Sophia MastDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Simon KrostDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.ORCID 0009-0000-4257-4334
Moustafa Moustafa-OglouDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Sophia ScheuermannDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Beate KristmannDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.ORCID 0009-0005-8299-5316
Maximilian FeigeDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Aysegül CanakDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Kathrin WolsingDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Lennart SchlagerDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.ORCID 0009-0004-7536-0657
Karin SchilbachDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.ORCID 0000-0001-8041-055X
Latifa ZekriClinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Tübingen, Germany.
Martin EbingerDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.ORCID 0000-0002-4229-8058
Daniel NixdorfDepartment of Medicine III, University Hospital, LMU, Munich, Germany.
Marion SubkleweDepartment of Medicine III, University Hospital, LMU, Munich, Germany.ORCID 0000-0001-9154-9469
Johannes SchulteDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Claudia LengerkeDepartment of Internal Medicine II, Hematology, Oncology, Clinical Immunology, and Rheumatology, University Hospital Tübingen, Tübingen, Germany.ORCID 0000-0001-5442-2805
Irmela JeremiasResearch Unit Apoptosis in Hematopoietic Stem Cells, Helmholtz Center Munich, Munich, Germany.ORCID 0000-0003-1773-7677
Niels WerchauR&D Department, Miltenyi Biotec B.V. & CO. KG, Bergisch Gladbach, Germany.
Joerg MittelstaetR&D Department, Miltenyi Biotec B.V. & CO. KG, Bergisch Gladbach, Germany.
Peter LangDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Rupert HandgretingerDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany.
Patrick SchlegelSchool of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.ORCID 0000-0002-5425-2049
Christian M SeitzDepartment of General Pediatrics, Hematology and Oncology, University Children's Hospital, Tuebingen, Germany. christian.seitz@med.uni-heidelberg.de.ORCID 0000-0002-0520-7866

Funding

Deutsche Forschungsgemeinschaft (German Research Foundation) 411791562
6 · The paper itself

Abstract

Targeting AML by chimeric antigen receptor T-cells (CAR-T) is challenging due to the promiscuous expression of AML-associated antigens in healthy hematopoiesis and high degree of inter- and intratumoral heterogeneity. Here, we present single-cell expression data of AML-associated antigens in 30 primary pediatric AML samples. We identified CD33, CD38, CD371, IL1RAP and CD123 as the most frequently expressed. Notably, high variability was observed not only across the different patient samples but also among leukemic cells of the same patient suggesting the necessity of multiplexed targeting approaches. To address this need, we utilized our modular Adapter CAR (AdCAR) platform, enabling precise qualitative and quantitative control over CAR-T-cell function. We show highly efficient and target-specific activity for newly generated adapter molecules (AMs) against CD33, CD38, CD123, CD135 and CD371, both in vitro and in vivo. We reveal that inherent intratumoral heterogeneity in antigen expression translates into antigen escape and therapy failure to monotargeted CAR-T therapy. Further, we demonstrate in PDX models that rational combinatorial targeting by AdCAR-T-cells can cure heterogenic disease. In conclusion, we elucidate the clinical relevance of heterogeneity in antigen expression in pediatric AML and present a novel concept for precision immunotherapy by combinatorial targeting utilizing the AdCAR platform.

Indexed as

Immunotherapy, AdoptiveLeukemia, Myeloid, AcuteReceptors, Chimeric AntigenAnimalsAntigens, NeoplasmChildHumansMiceT-LymphocytesXenograft Model Antitumor AssaysAntigens, NeoplasmReceptors, Chimeric Antigen

Identifiers

PMID39095503
PMCPMC11436361

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.