Novel KIR‑CAR T Approach Shows Early Activity Against Solid Tumors

CAR T cell therapies have revolutionized outcomes for certain blood cancers, yet their impact on solid tumors has lagged. The field has long wrestled with T cell exhaustion—a state in which engineered cells lose their potency and fail to sustain an anti‑tumor response.

At this year’s AACR annual meeting in San Diego, researchers from the Perelman School of Medicine at the University of Pennsylvania presented first‑in‑human Phase I data pointing to a possible solution. Their novel “KIR‑CAR” T cell therapy demonstrated a favorable safety profile and early signals of activity across multiple solid tumor types.

The investigational therapy, SynKIR-110, represents a departure from traditional CAR T designs. Rather than using a single-chain receptor, the therapy is modeled after natural killer (NK) cell receptors and uses a “multi-chain” architecture.

This design separates tumor recognition from activation, effectively creating an intrinsic “on-off” mechanism. The T cell remains in a resting state until it encounters its target, at which point the receptor components assemble to trigger an immune attack.

“The KIR-CAR design provides a natural ‘on-off’ mechanism, which helps avoid the problem of T cell exhaustion,” said Janos L. Tanyi, MD, PhD, principal investigator of the study. “The CAR turns on when it finds its target, kills it, and then rests, rather than constantly burning energy.”

This contrasts with conventional CAR T cells, which remain continuously active and can become depleted over time, limiting their effectiveness—particularly in the more complex microenvironment of solid tumors.

The Phase I dose-escalation trial enrolled nine patients with advanced, mesothelin-expressing cancers, including ovarian cancer, mesothelioma, and cholangiocarcinoma. These patients had limited treatment options, having received an average of four prior lines of therapy.

Although the primary goal of the study was to assess safety, early signs of efficacy were observed. Disease stabilization was reported in four patients, and one patient in the highest dose cohort achieved an ongoing partial response.

“These are cancer types that have never had an approved cell therapy,” Tanyi said. “We’re seeing good efficacy signals, even at low doses, and limited toxicity.”

The results suggest that the therapy may be able to generate meaningful anti-tumor responses even in heavily pretreated populations.

Safety has been another major barrier for CAR T therapies, particularly in solid tumors. However, the KIR-CAR approach appears to mitigate some of these concerns.

No dose-limiting toxicities were observed in the initial cohorts. Cytokine release syndrome (CRS), a common side effect of CAR T therapy, occurred in 33% of patients but was limited to low-grade events. Notably, there were no cases of immune effector cell-associated neurotoxicity syndrome (ICANS), a more severe complication sometimes seen with CAR T therapies.

The ability to limit toxicity while maintaining activity is a key step toward broader application of cell therapies in solid tumors.

SynKIR-110 targets mesothelin, a protein expressed on the surface of several solid tumors but largely absent from normal tissues. This makes it an attractive target for immunotherapy, particularly in cancers such as ovarian cancer and mesothelioma, where treatment options are limited.

The trial results indicate that the therapy’s activity is not confined to a single tumor type, raising the possibility of broader applicability across mesothelin-expressing cancers.

The findings come amid growing efforts to adapt CAR T technology for solid tumors. While the approach has revolutionized hematologic malignancies, solid tumors present additional challenges, including immunosuppressive microenvironments, physical barriers to T cell infiltration, and antigen heterogeneity.

Researchers are exploring multiple strategies to address these barriers, including improved targeting, combination therapies, and next-generation receptor designs such as KIR-CAR.

As noted by CAR T pioneer Carl June, MD, advancing cellular therapies into solid tumors remains a central goal for the field.

The Phase I study continues to enroll patients, aiming for a 42‑person cohort to define the maximum tolerated dose ahead of Phase II. Early readouts show that CAR T expansion rises with dose, a pattern that may translate into stronger anti‑tumor activity at higher levels.

While still preliminary, the findings highlight the potential of multi‑chain CAR designs to sustain activity without added toxicity. If confirmed, KIR‑CAR therapies could usher in a new generation of engineered immune cells that more closely mirror natural immune regulation.

For now, the data offer a promising sign that CAR T innovation may finally be gaining ground in solid tumors.

The post Novel KIR‑CAR T Approach Shows Early Activity Against Solid Tumors appeared first on GEN – Genetic Engineering and Biotechnology News.

<![CDATA[Psychiatry experts explain why off-label psych meds and polypharmacy can be essential.]]>

Earliest Events of Lung Cancer Development Mapped

Researchers at Memorial Sloan Kettering (MSK) Cancer Center have identified the earliest cellular and molecular events that create the needed conditions for lung cancer cells to begin their growth into a tumor. The study, published in Nature, describes how cells with cancer-causing mutations initiate a coordinated chain of events to involve nearby fibroblasts and immune cells to create a microenvironment conducive to tumor growth at the very start of disease.

“We also found that this transformation of the local neighborhood is reversible, if caught early enough. This opens the door to new treatment and prevention strategies,” said senior author Joo-Hyeon Lee, PhD, an associate member in the developmental biology program at MSK.

The research focused on lung alveolar type II (AT2) stem cells that acquire mutations in the KRAS gene. Rather than simply proliferating, the mutant cells enter a regenerative-like state that resembles tissue repair. In this state, they produce amphiregulin (AREG), a signaling molecule that initiates communication with surrounding cells. AREG activates nearby fibroblasts through EGFR signaling, which prompts them to adopt a fibrotic, injury-like state which results in a remodeling of the extracellular matrix.

Within the microenvironment created, fibroblasts play a central role in shielding emerging tumor cells by producing a fibrous scaffold that supports tumor growth while also releasing signals that alter the activity of immune cells. Macrophages recruited to the site undergo reprogramming, shifting away from fighting the tumor toward phenotypes that suppress immune responses. Neutrophils and regulatory T cells are also recruited, further dampening anti-tumor immunity. This coordinated activity creates a protective niche in which the cells with the KRAS mutation can grow without being eliminated.

“These reciprocal interactions establish a self-sustaining epithelial–stromal–immune circuit that generates a tumor-permissive niche before malignant outgrowth,” the researches wrote. This loop reinforces itself: mutant cells sustain fibroblast activation, fibroblasts reshape immune responses, and immune cells further support tumor-promoting conditions.

The study builds on prior research in the Lee lab into lung injury and repair, which showed that normal regenerative programs involve temporary activation of stem cells and fibroblasts. In cancer, however, this process becomes dysregulated. Mutant cells remain locked in a regenerative state, continuously signaling to their environment. Earlier work by the same group had identified these regenerative states as a feature of early tumorigenesis.

To identify the mechanisms involved, the MSK first used mouse models of lung cancer carrying KRAS mutations. Through lineage tracing and single-cell analyses, they tracked individual cells to map how interactions with fibroblasts and immune cells evolved over time. They then used tissue samples from patients with early-stage lung adenocarcinoma and found returned the same result of cancer cells producing high levels of AREG and adjacent fibrotic fibroblasts.

Importantly, the team demonstrated that disrupting this communication network can prevent tumor formation. Blocking AREG signaling with an EGFR inhibitor kept fibroblasts and immune cells in their normal states and significantly impaired tumor development. Similarly, removing the AREG gene from mutant cells prevented the formation of the tumor-supportive niche. Even after early lesions had formed, inhibiting KRAS activity reversed many of the changes that had already occurred in the microenvironment.

The implications of this research to influence for cancer care are substantial. The identification of early signaling events and microenvironmental changes suggests new biomarkers for detecting lung cancer before it becomes advanced. High levels of AREG or evidence of fibroblast activation could indicate the presence of precancerous lesions, which could be particularly important for screening those at high risk of developing cancer, such as long-term smokers.

The findings also suggest there could be the development of new therapeutics aimed at preventing cancer development as opposed to treating it once it is established. By targeting the AREG–EGFR signaling axis or disrupting fibroblast activation, clinicians may be able to block tumor development at its earliest stages. Because the team showed these processes can be reversed, there is a window for intervention before the disease becomes resistant to treatment.

“The reversibility of these preneoplastic circuits defines a therapeutic window before progression to treatment-resistant disease,” the researchers wrote.

Next steps for the team include validating biomarkers in clinical populations, refining organoid models to study patient-specific tumor development, and testing preventive therapies that target these newly identified early signaling pathways.

The post Earliest Events of Lung Cancer Development Mapped appeared first on Inside Precision Medicine.

Transcutaneous auricular vagus nerve stimulation for paroxysmal sympathetic hyperactivity syndrome after intracerebral hemorrhage: a hypothesis-generating case report

ObjectiveTo observe the clinical effect of transcutaneous auricular vagus nerve stimulation (taVNS) in drug-refractory paroxysmal sympathetic hyperactivity (PSH).MethodsThis case report describes the clinical course of a 63-year-old male with PSH following intracerebral hemorrhage. PSH episodes were characterized by tachypnea, tachycardia, hypertension, and increased muscle tone. After 2 weeks of combination pharmacotherapy (propranolol, baclofen, gabapentin), blood pressure, heart rate, and muscle tone improved, but tachypnea remained inadequately controlled. Although sedative agents alleviated tachypnea, they led to decreased consciousness level and could not be continued. Subsequently, taVNS was added to the ongoing pharmacotherapy.ResultsAfter 4 weeks of taVNS treatment, PSH episode frequency and tachypnea improved. Baclofen and gabapentin were discontinued, propranolol dosage was reduced, and the patient’s consciousness level showed improvement. After another 4 weeks of continued treatment, only mild tachypnea occurred occasionally under strong stimulation, without other sympathetic symptoms. Consciousness level further improved.ConclusionThis case suggests that taVNS may be a safe adjunctive intervention option for drug-refractory PSH. The symptom relief and consciousness improvement observed during treatment may be related to the application of taVNS.

Functional methods for evaluating the efficacy of retinal optogenetic therapy for vision restoration

Optogenetic therapy is a promising strategy for vision restoration. Functional assays have an important role in assessing the modulation of neural activity in response to light stimulation. Each functional assay needs to be carefully considered and evaluated for the preclinical development of optogenetic approaches to work toward meaningful vision restoration. Each strategy contributes to understanding the efficacy of vision restoration and the physiology of retinal optogenetic therapy. At a molecular level, bioluminescence resonance energy-transfer based and G protein coupling assays can be used. Calcium imaging provides measurements with useful spatial and temporal resolution using fluorescent calcium indicators at the cellular level. Electrophysiological tests can include ex vivo recordings by patch-clamping at single-cell resolution, multielectrode array recordings at the network level, and in vivo recordings at the lateral geniculate nucleus and cortical levels. Behavioural tests such as light avoidance, optomotor response and visual discrimination assess functional restoration in vivo. In this review, each functional assay is discussed in the context of retinal optogenetic therapy with notable examples that have demonstrated vision restoration. The advantages, disadvantages, and limitations of each assay are critically compared to highlight their relative scientific value and applicability across different stages of development. This provides insight into how these methods can be integrated within a translational framework, from molecular validation to behavioural outcomes, to better inform the design of preclinical studies. As clinical trials in optogenetic therapy continue to expand, improved alignment between preclinical functional assays and clinically meaningful endpoints will be essential to maximise translational success.

Speech recognition performance with dual-microphone audio processors in mandarin-speaking cochlear implant users

BackgroundCochlear implant (CI) audio processor upgrades have demonstrated speech recognition benefits in non-tonal language populations, but high-level evidence for native Mandarin-speaking CI users (a tonal language with unique signal processing requirements) remains critically limited. This study aimed to assess the speech perception performance of the SONNET 2 and RONDO 3 dual-microphone audio processors in native Mandarin-speaking CI users.MethodsThis prospective single-subject repeated-measures study enrolled 51 native Mandarin-speaking CI users. Speech recognition performance was tested across five processor configurations: the legacy baseline processor, SONNET 2 (S2) in omnidirectional (S2.OMNI) and adaptive intelligence (S2.Adaptive) modes, and RONDO 3 (R3) in omnidirectional (R3.OMNI) and adaptive intelligence (R3.Adaptive) modes. Outcome measures included monosyllabic words, disyllabic words, and sentence recognition in quiet, and sentence recognition in co-located speech-shaped noise (S0N0 paradigm). The pre-specified primary endpoint was sentence recognition in noise for S2.OMNI vs. the legacy processor; confirmatory linear mixed-effects models (LMMs) and subgroup analyses were exclusively performed for the primary endpoint, with pairwise comparisons for all secondary exploratory endpoints.ResultsIn quiet, all four upgraded configurations yielded significantly higher monosyllabic word recognition scores vs. the legacy baseline (all p < 0.05, FDR-adjusted); all configurations except R3. Adaptive showed significant improvements in disyllabic word recognition (all p < 0.05, FDR-adjusted). In the S0N0 noise condition, S2.OMNI and R3.OMNI significantly enhanced sentence recognition vs. the legacy processor (p < 0.001 and p = 0.011, respectively, FDR-adjusted), while no significant benefit was detected for either adaptive mode after FDR correction. LMM analysis confirmed that upgrading to the S2.OMNI configuration was an independent positive predictor of noise sentence recognition (F = 9.885, p = 0.003), with consistent significant benefits across pediatric/adult and unilateral/bilateral users in pre-specified subgroup analyses.ConclusionThis study provides confirmatory evidence that upgrading to the S2.OMNI configuration significantly improves sentence recognition in noise in native Mandarin-speaking CI users, with consistent benefits across key clinical subgroups. Exploratory analyses show that the S2 and R3 processors also deliver significant improvements in word recognition in quiet, These results fill a critical evidence gap for tonal language CI populations and may help guide clinical device selection.

Intracerebroventricular diphtheria toxin causes off-target toxicity in CD11b-DTR and wild-type mice, revealing limitations of DTR-based depletion studies

Diphtheria toxin receptor (DTR)–based depletion models are widely used to study microglial and macrophage function, yet the extent to which diphtheria toxin (DT) produces off-target effects remains incompletely defined. Here, we examined tolerability, behavioural outcomes, and cellular responses following intracerebroventricular (i.c.v.) DT administration in wild-type (WT) and CD11b-DTR mice. Mice received bilateral i.c.v. infusions of DT or vehicle over a 10-day period and were assessed for survival, motor and cognitive behaviour, myeloid cell changes, and neuropathology. Unexpectedly, DT induced dose-dependent mortality in WT mice, demonstrating that toxicity can occur independently of DTR expression. CD11b-DTR mice exhibited greater susceptibility, with reduced survival and the emergence of illness at lower DT doses. Behavioural testing revealed significant dose-dependent impairments in rotarod performance and Y-maze spontaneous alternation in both genotypes, while open-field mobility was largely preserved among animals. Region-specific analysis of myeloid cells in CD11b-DTR mice showed robust depletion in the midbrain at higher DT doses, whereas hippocampal cell numbers remained unchanged with marked morphological signs of activation. These findings indicate that DT-mediated myeloid cell responses vary across brain regions, potentially reflecting differential toxin exposure following ventricular delivery. Consistent with this, focal abnormalities in the brain—including ventriculitis, meningoencephalitis and spongiotic changes—were observed in a subset of clinically affected DT-treated animals, whereas peripheral organs were largely unremarkable and haematological changes were infrequent. Together, these data demonstrate that i.c.v. DT administration can induce mortality, behavioural dysfunction, and focal CNS pathology in both WT and CD11b-DTR mice, with transgene expression amplifying susceptibility. Our findings highlight the need for careful dose optimisation, appropriate DT-treated controls, and cautious interpretation of behavioural phenotypes when employing this model.

Cortical activity during cognitive and walking tasks in individuals with chronic nonspecific low back pain: a functional near-infrared spectroscopy study

IntroductionPrevious research demonstrates that individuals with chronic nonspecific low back pain (CNSLBP) exhibit changes of gait patterns. However, the neural mechanisms responsible for these adverse events remain unelucidated. In this study, we used functional near-infrared spectroscopy (fNIRS) to investigate cortical activities during cognitive and walking tasks to provide evidence of the central mechanisms responsible for changes of gait patterns in individuals with CNSLBP.MethodsIn this cross-sectional study, we evaluated 18 individuals with CNSLBP (the CNSLBP group) and 18 healthy controls (the HC group) under three specific conditions: Task 1 (a single walking task), Task 2 (a single cognitive task) and Task 3 (a cognitive-walking dual task). Cortical activities were measured using fNIRS, including the bilateral premotor cortex and supplementary motor area (PMC/SMA), primary motor cortex (M1), somatosensory association cortex (SAC), and primary somatosensory cortex (S1). Gait parameters, including step duration, step length, stride length, velocity, cadence, swing power, and cycle, were measured using a three-dimensional gait analysis system.ResultsIn Task 1, the CNSLBP group exhibited a significantly lower velocity (p = 0.029) and higher activation in the left SAC (p = 0.001) and right S1 (p = 0.018) than that of the HC group. In Task 2, the CNSLBP group exhibited higher activation in the left SAC (p = 0.028), right SAC (p = 0.033), and left S1 (p = 0.032). In Task 3, the CNSLBP group exhibited significantly lower step length (p = 0.031), stride length (p = 0.041), velocity (p = 0.016), and swing power (p = 0.047). Correlation analysis in Task 1 revealed stronger associations between parameters in the CNSLBP group.ConclusionOur findings suggest that individuals with CNSLBP exhibit distinct patterns of cortical activities and gait performance. The SAC and S1 were involved in walking, and central sensitization was observed in individuals with CNSLBP in daily cognitive and walking tasks. These findings could contribute to the recovery and rehabilitation of CNSLBP.

Psychiatric comorbidities and sexual health risks in HIV-serodiscordant heterosexual couples involving women with borderline personality disorder: a mixed-method study and theoretical modeling

BackgroundHIV-serodiscordant heterosexual couples consist of one partner who is HIV-positive and the other who is HIV-negative. Our previous studies found that the HIV-negative female partner in no-prevention couples (NPC) may be affected by borderline personality disorder (BPD) and might have a history of child abuse, trauma, and neglect. These couples provide valuable insights into public health, particularly regarding health behaviors and psychosocial factors that influence the relationship between psychopathology, illness behaviors related to borderline personality disorder, and the transmission of sexually transmitted diseases.Population and methodsThis study was conducted in three sequential phases. Phase One involved a cross-sectional, multicenter, anonymous survey of 175 HIV-serodiscordant couples, aimed at assessing preventive sexual behaviors. Participants reported sexual protection use during at-risk sexual encounters on a scale ranging from 0% (‘never’) to 100% (‘always’). Phase Two, which constitutes the core of the present investigation, employed qualitative, unstructured interviews and narrative analysis with HIV-negative female partners in serodiscordant relationships. The analytic focus was on identifying patterns of psychopathological comorbidity and health-related behaviors. Through iterative narrative synthesis and thematic coding, the presence of Borderline Personality Disorder (BPD) emerged consistently across cases. The confirmation of BPD as a clinical diagnosis was thus an outcome of this phase, derived from converging narrative indicators and psychopathological profiles rather than a pre-established inclusion criterion. Phase Three, drawing on the findings from both preceding phases, involved developing a theoretical model of the observed behavioral patterns. Integrating quantitative trends from Phase One with the qualitative insights from Phase Two, we developed a conceptual framework to explain the interaction between BPD-related psychopathology, relational dynamics, and HIV (or other sexually transmitted diseases) risk behaviors. This model aims to guide future healthcare strategies for HIV-negative women with BPD in serodiscordant relationships, a group identified as particularly vulnerable to sexually transmitted HIV due to compromised primary prevention.ResultsSpecific health belief models and behaviors related to health emerged among HIV-negative female partners with BPD who decline prevention during behaviors that put them at risk for HIV sexual transmission in stable relationships with HIV-positive males. Results illustrate that women with BPD who have a history of child abuse and trauma often exhibit comorbid self-defeating personality disorder (SDPD), dependent personality disorder (DPD), and complex post-traumatic stress disorder (CPTSD). We could not replicate similar findings in HIV negative males.ConclusionsThe current study confirms that health behaviors and women’s health may be influenced by underlying personality, behavioral, and psychosocial factors, which public health policymakers must address to improve primary prevention of transmissible diseases. We suggest that child abuse, neglect, and trauma may be connected to overlooked health behaviors across a person’s entire life span.

Psychological function in the context of protracted stress during war: a multi-sample, multivariate longitudinal study

Continuous traumatic stress has wide-ranging implications for important life outcomes across multiple domains. We present the design protocol from the first waves of one of the most comprehensive studies of the impact of one pervasive continuous traumatic stress context—war—on individuals. In this ongoing project we have been collecting quantitative and qualitative data on psychological function, risk, and resilience at different levels of influence and at various junctures during the ongoing 2023–2025 Hamas-Israel war from three samples (total N = 16,330). We present this large-scale, multi-sample, multivariate, mixed-method, longitudinal study, and showcase select, preliminary findings at different levels of analysis and in different samples (e.g., concerning war exposure, trust in institutions, and well-being). We document the design, scope, and future trajectory of the project, encouraging interdisciplinary, cross-border collaborations among researchers across diverse fields. This is important not only for understanding responses to the current conflict, but also for understanding risk and resilience in other conflict-affected regions and among populations facing continuous traumatic stress more broadly.