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Precision In Vivo CAR-T generation via CLAMP-enabled mRNA delivery: Toward scalable and translatable cell therapy

Jingwei Sun, Xi Zhu, Xu Zhao, Jiahui Jin, Jingman Wang, Yiyang Tan, Dalang Li, Hong Chen, Jiaming Ren, Pin Wang, Yarong Liu

2025Blood6 citationsDOIOpen Access PDF

Abstract

Abstract Background:Chimeric Antigen Receptor (CAR) T cell therapies have transformed the treatment landscape of hematological malignancies and offer curative potential to certain patients. However, autologous CAR-T therapies encounter key challenges, including toxicity from lymphodepletion, complex ex-vivo manufacturing and high cost, all of which limits broader clinical application. In vivo CAR-T therapy is an emerging modality designed to overcome these barriers by enabling direct T cell engineering within patients. Effective in vivo CAR-T therapy requires targeted T cell delivery, durable CAR expression, potent cytotoxic activity, and potential for re-dosing. Toward this goal, we report the development and preclinical evaluation of GT801, a novel anti-CD19 in vivo CAR-T candidate. Methods:GT801 was developed using novel T-cell-targeted lipid nanoparticles (T-LNP) encapsulating chemically modified linear mRNA encoding an anti-CD19 CAR gene. Both LNP formulation and mRNA design were systematically optimized to enhance delivery specificity, promote robust CAR expression, and maximize CAR-T functionality. T-LNPs were surface-engineered with a VHH antibody directed against a T cell-specific target, enabling selective uptake by endogenous T cells. Antibody conjugation to the LNP surface was achieved using CLAMP (Controllable Ligand Attachment Modification and Purification), a proprietary technology that enables site-specific antibody attachment and precise control of ligand density. This approach enhances targeting efficiency while minimizing non-specific uptake. GT801 was thoroughly characterized for purity, identity, potency, and biodistribution. Anti-tumor efficacy and pharmacokinetics/pharmacodynamics (PK/PD) were assessed in vitro and in vivo using humanized NOG mouse models. Results:When combined with optimized mRNA chemistry, the T-LNP platform enables robust and sustained CAR expression in human PBMC, with expression persisting for over 14 days in vitro. In human PBMC-engrafted NOG mice, a single intravenous dose as low as 0.01 mg/kg achieved >95% B cell depletion. The conjugation strategy and stealth-layer design minimized off-target uptake by monocytes, macrophages, and dendritic cells to below 3%. By targeting T cell-specific markers, the system achieved receptor-saturating delivery efficiency across multiple lymphoid tissues at clinically relevant doses, driving >30-fold in vivo expansion of CAR-T cells. Potent antitumor activity was demonstrated in CDX (cell line-derived xenograft) model following a single or multiple dosing. The LNP formulation incorporates proprietary ionizable lipids with favorable PK and safety profiles across multiple species. Serial dosing elicited minimal cytokine release (IL-6, TNF-α), supporting the safety and re-dosing potential of this platform. Conclusion:These findings demonstrate that our T-LNP platform enables efficient, targeted, and sustained in vivo CAR expression with a favorable safety profile and scalable manufacturing process. A clinical batch is currently in production, and a first-in-human investigator-initiated trial (IIT) in B cell malignancies is anticipated to launch in late 2025.

Topics & Concepts

In vivoChimeric antigen receptorIn vitroCell therapyChemistryAntibodyCellEx vivoCancer researchMessenger RNAGenetic enhancementCytotoxic T cellImmunotherapyCell biologyReceptorAntigenCell cultureDrug deliveryCytotoxicityLigand (biochemistry)Computational biologyMonoclonal antibodyT cellImmunogenicityHumanized mouseAntibody-drug conjugateTargeted therapyCombination therapyBiologyCAR-T cell therapy researchCRISPR and Genetic EngineeringRNA Interference and Gene Delivery