Impact of mixed versus separate CD4+ and CD8+ CAR T cell cultures on in vivo antitumor activity. NSG mice (n=8 per experimental group, n=5 for untransduced and no treatment groups, n=1 for no tumor group) bearing 7 day Raji-ffLuc tumors, received a suboptimal dose of 2×106 tCD19+ 1.5.3-NQ-28-BB-z CD20-targeted CAR T cells cultured at a 60:40 CD4:CD8 ratio or expanded in separate parallel CD4+ and CD8+ cultures and formulated at a 1:1 ratio prior to injection. The mixed cells were at a 1:1.9 CD4:CD8 ratio at the time of infusion. Untransduced T cells expanded in mixed cultures were included as a control. Mice were imaged twice weekly by bioluminescence imaging. (A) Experimental schema. (B) Average tumor burden per group over time as measured by total body bioluminescence. The mean luminescence values±SEM are shown. The tumor burden over time was greater in the separate group compared with the mixed group based on a two-way repeated measures ANOVA, time x treatment group, F
(3, 42)=34.64, p<0.0001; time factor, F
(1.158, 16.21)=40.05, p<0.0001; treatment group factor, F
(1, 14)=37.24, p<0.0001. (The overall model including no treatment, untransduced, separate, and mixed groups showed: time x treatment group, F
(9, 84)=21.49, p<0.0001; time factor, F
(1.054, 29.51)=76.63, p<0.0001; treatment group factor, F
(3, 28)=35.70, p<0.0001; for one mouse who died between day 15 and day 19 in the no-treatment group, the day 15 body flux value was carried forward as the day 19 value). (C) Dorsal images of each mouse at day 19 are shown. ANOVA, analysis of variance; CAR, chimeric antigen receptor.